Individual provider Active NPI

Shanoor Khan, PA

  • Physician Assistant
  • Corona, CA
National Provider Identifier
1326391368
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
57883 Issued in CA
Practice address
2071 Compton Ave Ste 102
Corona, CA 92881-7279
Phone
(951) 549-0900
NPI assigned
Oct 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 57883 CA Primary

Addresses

Primary practice location

2071 Compton Ave Ste 102
Corona, CA 92881-7279

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3203

Other practice location 1

14252 Schleisman Rd Ste 100
Eastvale, CA 92880-4026
Phone (951) 941-0900

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240502001590 CA Practitioner - Physician Assistant 8325283385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1236 N Magnolia Ave
Anaheim, CA 92801-2607
Phone (714) 995-1000

14252 Schleisman Rd
Suite 100
Eastvale, CA 92880-4026
Phone (951) 941-0900

5957 W Ramsey St
Banning, CA 92220-3058
Phone (951) 845-0313

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
57883CAMDDentist
5306AZMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group CurrentSince Apr 1, 2024 Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

2910 Jefferson St
Ste 100
Carlsbad, CA 92008
Phone (760) 729-8600

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

14252 Schleisman Rd
Ste 100
Eastvale, CA 92880
Phone (951) 941-0900

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

Interoperability endpoints

  • Direct secure messaging: s.khan@nwami-ca.direct.office.nextgen.com

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": "1350259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1326391368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2071 COMPTON AVE STE 102",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928817279",
            "telephone_number": "951-549-0900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14252 Schleisman Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Eastvale",
            "state": "CA",
            "postal_code": "928804026",
            "country_code": "US",
            "telephone_number": "951-941-0900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SHANOOR",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-15",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.