KMK Medical Service, P.C.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

KMK MEDICAL SERVICE, P.C.

Practice address

14742 Newport Ave Ste 209
Tustin, CA 92780-6177

Phone

(949) 395-5835

NPI assigned

Apr 5, 2022

Organization subpart

No

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

Authorized official

Name

Kevin Khouie, MD

Title

Ceo

Phone

(949) 395-5835

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649116800000",
    "number": "1396486197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3334 E COAST HWY # 713",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926252328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14742 NEWPORT AVE STE 209",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806177",
            "telephone_number": "949-395-5835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KMK MEDICAL SERVICE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A",
        "authorized_official_last_name": "KHOUIE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-395-5835",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Tustin, CA
• Providers in Tustin, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.