NPIMap

Individual provider Active NPI

Mansurur R. Khan, MD

  • Internal Medicine Physician
  • Pomona, CA
National Provider Identifier
1326196312
Registry record updated May 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A72399 Issued in CA
Practice address
1940 N Orange Grove Ave
Suite C
Pomona, CA 91767-3002
Phone
(909) 524-1940
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A72399 CA Primary

Addresses

Primary practice location

1940 N Orange Grove Ave
Suite C
Pomona, CA 91767-3002

Mailing address

1940 N Orange Grove Ave
Suite C
Pomona, CA 91767-3002
Phone (909) 524-1940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130507000044 CA Practitioner - Internal Medicine 1557348141 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Vermont College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Hospitalist IncGroup PAC ID 5092814038, 17 clinicians

Practice addresses (Care Compare)

1042 San Bernardino Rd
Upland, CA 91786-4921
Phone (909) 524-1940

255 E Bonita Ave
Pomona, CA 91767-1923
Phone (909) 941-0661

7974 Haven Ave
Suite 210
Rancho Cucamonga, CA 91730-3052
Phone (909) 941-0661

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
United Hospitalist Inc. Internal Medicine CurrentSince May 1, 2011 Accepting new patients
Prohealth Partners, a Medical Group Internal Medicine Current Accepting new patients
Casa Colina Hospital and Centers for Healthcare Current Accepting new patients
Prohealth Partners, a Medical Group, Inc. Internal Medicine CurrentSince Jan 5, 2013 Accepting new patients
Prohealth Partners a Medical Group Inc Internal Medicine CurrentSince Jan 5, 2013 Accepting new patients
San Antonio Regional Hospital Past Accepting new patients
Prohealth Partners a Medical Group Inc Internal Medicine Past Accepting new patients
Inland Valley Infectious Disease Medical Group Inc Past Accepting new patients

Locations

2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000

3801 Katella Ave
Ste 330
Los Alamitos, CA 90720
Phone (562) 594-9546

File 54567
Los Angeles, CA 90074
Phone (310) 491-9060

255 E Bonita Ave
Ste 1
Pomona, CA 91767

255 E Bonita Ave
Ste 101
Pomona, CA 91767
Phone (909) 593-7437

255 E Bonita Ave
Pomona, CA 91767
Phone (866) 724-4127

1940 N Orange Grove Ave
Ste C
Pomona, CA 91767
Phone (909) 524-1040

255 E Bonita Ave
Bldg 1
Pomona, CA 91767
Phone (909) 524-1940

7974 Haven Ave
Ste 210
Rch Cucamonga, CA 91730
Phone (909) 941-0661

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: casacolina@direct.casacolina.org

Organizations & group practices 8

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335830400000",
    "number": "1326196312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 N ORANGE GROVE AVE",
            "address_2": "SUITE C",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673002",
            "telephone_number": "909-524-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 N ORANGE GROVE AVE",
            "address_2": "SUITE C",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673002",
            "telephone_number": "909-524-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MANSURUR",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2012-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A72399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.