Active NPI
Afram S Kallah, MD
- Family Medicine Physician
- Santa Ana, CA
National Provider Identifier
1376586644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A69375
- Practice address
- 550 N Flower St
Santa Ana, CA 92703-2361 - Phone
- (714) 647-4170
- Fax
- (888) 959-3949
- NPI assigned
- Jun 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A69375 | CA | Primary |
Addresses
Primary practice location
550 N Flower St
Santa Ana, CA 92703-2361
Mailing address
PO Box 1071
Los Alamitos, CA 90720-1071
Phone (714) 647-4170
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A693750 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A69375 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pathway Medical Group, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Anaheim, CA
- NPI 1407199243
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397779200000",
"number": "1376586644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1071",
"city": "LOS ALAMITOS",
"state": "CA",
"postal_code": "907201071",
"telephone_number": "714-647-4170",
"fax_number": "888-959-3949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 N FLOWER ST",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927032361",
"telephone_number": "714-647-4170",
"fax_number": "888-959-3949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KALLAH",
"first_name": "AFRAM",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-14",
"last_updated": "2014-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A69375",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A693750",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.