Khaled Ahmed Aly Mawaheb, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A96423 Issued in CA

Practice address

1433 N Hollenbeck Ave
Suite 200
Covina, CA 91722-1558

Phone

(626) 331-2209

NPI assigned

Jan 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Mayflower Medical Group, Inc.

  • Internal Medicine Physician
  • West Covina, CA
  • NPI 1003188160

  Family Medicine

  Medicare reassignment NPD
• Mayflower Medical Group, Inc.

  • Family Medicine Physician
  • Covina, CA
  • NPI 1932146370
  NPD
• Emanate Health Medical Center

  dba Citrus Valley Medical Center Queen Of the Valley Campus

  • General Acute Care Hospital
  • West Covina, CA
  • NPI 1063441293
  NPD (past)

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1356492888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1433 N HOLLENBECK AVE",
            "address_2": "SUITE 200",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917221558",
            "telephone_number": "626-331-2209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1433 N HOLLENBECK AVE",
            "address_2": "SUITE 200",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917221558",
            "telephone_number": "626-331-2209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAWAHEB",
        "first_name": "KHALED",
        "middle_name": "AHMED ALY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A96423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryon Matsuda, PH.D, CCC-SLP
• Ashley Nicole Matthews, PT
• Lakisha Rene Matthews
• Iqbal Thein Maung, PH.D.
• Carlos Mauriz, MSW
• Steven Paul Maxam
• Lauren Camille May
• Portia May
• Barbara Mayberry
• Mayflower Medical Group, Inc.

• Family Medicine Physician in Covina, CA
• Providers in Covina, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.