Individual provider Active NPI

Tanzim Khan, DPM

  • Podiatrist
  • Los Angeles, CA
National Provider Identifier
1316344138
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E5403 Issued in CA
Practice address
1520 San Pablo St Ste 4300
Los Angeles, CA 90033-5330
Phone
(323) 442-5849
NPI assigned
Nov 21, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 25MD00337300 NJ
Podiatrist 213E00000X N006848-1 NY
Podiatrist 213E00000X E5403 CA Primary

Addresses

Primary practice location

1520 San Pablo St Ste 4300
Los Angeles, CA 90033-5330

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-5849

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tanzim.khan@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180215001582 CA Practitioner - Podiatry 1658644562 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E5403CAMDPodiatrist
25MD00337300NJMDPodiatrist
N006848-1NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Feb 1, 2018 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Feb 1, 2018 Accepting new patients

Locations

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1520 San Pablo St
Ste 4300
Los Angeles, CA 90033
Phone (323) 442-5849

1450 San Pablo St
Ste HC46200
Los Angeles, CA 90033

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1416528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1316344138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-5849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SAN PABLO ST STE 4300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335330",
            "telephone_number": "323-442-5849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "TANZIM",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-21",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "25MD00337300",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N006848-1",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E5403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tanzim.khan@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1520 San Pablo St Ste 4300",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900335330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.