Individual provider Active NPI

Daniel Khakshooy, MD, MPH

  • Family Medicine Physician
  • Valencia, CA
National Provider Identifier
1376038406
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A173916 Issued in CA
Practice address
25775 McBean Pkwy Ste 215
Valencia, CA 91355-3703
Phone
(805) 644-9121
NPI assigned
Jul 1, 2018
Last updated
Dec 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A173916 CA Primary
Family Medicine Physician 207Q00000X T-3592 MS

Addresses

Primary practice location

25775 McBean Pkwy Ste 215
Valencia, CA 91355-3703

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-8771

Other practice location 1

6633 Telephone Rd Ste 112
Ventura, CA 93003-5569
Phone (805) 644-9121

Other practice location 2

2514 67th Avenue Loop Ste 112
Meridian, MS 39307-7260
Phone (601) 482-4955

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210809003515 CA Practitioner - Family Practice 7214331529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Medical Plaza
Los Angeles, CA 90095-0001

100 Medical PLZ
Suite 310
Los Angeles, CA 90095-0001
Phone (310) 825-7922

100 Moody CT
Suite 200
Thousand Oaks, CA 91360-6082
Phone (805) 418-3500

1245 16TH St
Santa Monica, CA 90404-1240

200 Medical Plaza
Los Angeles, CA 90095-0001

200 Medical PLZ
Los Angeles, CA 90095-0001

200 UCLA Medical PLZ
Suite 165 34
Los Angeles, CA 90095-0001
Phone (310) 824-8403

2020 Santa Monica Blvd
Suite 210
Santa Monica, CA 90404-2139
Phone (310) 458-2381

248 Hampshire Rd
Suite 100
Thousand Oaks, CA 91361-2401
Phone (805) 370-0040

900 Weyburn Place
Suite 14 171
Los Angeles, CA 90095-0001
Phone (310) 825-8173

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A173916CAMDFamily Medicine Physician
T-3592MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California Family Medicine CurrentSince Aug 1, 2021 Accepting new patients
The Regents of the University of California CurrentSince Aug 1, 2021 Accepting new patients
UCLA Medical Group Family Medicine Past Accepting new patients

Locations

24302 Paseo de Valencia
Ste 200
Laguna Hills, CA 92653
Phone (949) 458-8252

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 55737
Los Angeles, CA 90074

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

100 Moody Ct
Ste 200
Thousand Oaks, CA 91360
Phone (805) 418-3500

25775 McBean Pkwy
Ste 215
Valencia, CA 91355
Phone (661) 255-2420

27235 Tourney Rd
Ste 2500
Valencia, CA 91355
Phone (661) 253-5851

6633 Telephone Rd
Ste 112
Ventura, CA 93003
Phone (805) 644-9121

Interoperability endpoints

  • Direct secure messaging: daniel.khakshooy.1@18357.direct.athenahealth.com
  • Direct secure messaging: dkhakshooy897655@direct.uclahealth.org

Organizations & group practices 3

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

Hospital & facility affiliations 1

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": "1530403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1376038406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-8771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25775 MCBEAN PKWY STE 215",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913553703",
            "telephone_number": "805-644-9121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6633 Telephone Rd Ste 112",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "930035569",
            "country_code": "US",
            "telephone_number": "805-644-9121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2514 67th Avenue Loop Ste 112",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "MS",
            "postal_code": "393077260",
            "country_code": "US",
            "telephone_number": "601-482-4955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAKSHOOY",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-01",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A173916",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "T-3592",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

Verify at the official NPI Registry.