NPIMap

Individual provider Active NPI

Omer Khan, MD

  • Nephrology Physician
  • Torrance, CA
National Provider Identifier
1396036646
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A112831 Issued in CA
Practice address
2841 Lomita Blvd Ste 215
Torrance, CA 90505-5111
Phone
(310) 379-2860
Fax
(310) 325-1144
NPI assigned
Apr 20, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A112831 CA Primary

Addresses

Primary practice location

2841 Lomita Blvd Ste 215
Torrance, CA 90505-5111

Mailing address

3291 Skypark Dr
Torrance, CA 90505-5004
Phone (310) 325-4517

Other identifiers 1

IdentifierTypeStateIssuer
A112831OtherCAMEDICAL LICENSE

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
I20131106001489 CA Practitioner - NephrologyPractitioner - Internal Medicine 7719112358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of California, Geffen School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Internal Medicine and Nephrology Med. Group Inc.Group PAC ID 3173681400, 7 clinicians

Practice addresses (Care Compare)

3291 Skypark Dr
Torrance, CA 90505-5004
Phone (310) 325-4517

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A112831CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine and Nephrology Med. Group Inc. Nephrology CurrentSince Mar 1, 2016 Accepting new patients
Ahmc Monterey Park Hospital LP Past Accepting new patients
Eladh, LP Past Accepting new patients
Ahmc Greater El Monte Comm Hosp LLC Past Accepting new patients
Alta Los Angeles Hospital, Inc Past Accepting new patients
White Memorial Medical Center Past Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients
Southern California Healthcare System, Inc Past Accepting new patients
Providence Health System Southern California Past Accepting new patients

Locations

3291 Skypark Dr
Torrance, CA 90505
Phone (213) 325-4517

2841 Lomita Blvd
Torrance, CA 90505
Phone (310) 257-0508

2841 Lomita Blvd
Ste 215
Torrance, CA 90505
Phone (310) 379-2860

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: omk112pcs@m566.primeclinicalsystems.direct-ci.com

Organizations & group practices 9

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 9

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": "1303257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1396036646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3291 SKYPARK DR",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055004",
            "telephone_number": "310-325-4517",
            "fax_number": "310-325-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2841 LOMITA BLVD STE 215",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055111",
            "telephone_number": "310-379-2860",
            "fax_number": "310-325-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "OMER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A112831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A112831",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.