Individual provider Active NPI

Khalid Mohamed Eltawil, MD

  • Pulmonary Disease Physician
  • Torrance, CA
National Provider Identifier
1396724399
Registry record updated May 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
201645 Issued in CA
Practice address
3701 Skypark Dr
#200
Torrance, CA 90505-4749
Phone
(310) 378-8900
Fax
(310) 791-0786
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 201645 CA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 201645 CA
Pulmonary Disease Physician 207RP1001X 201645 CA Primary
Sleep Medicine (Internal Medicine) Physician 207RS0012X A66752 CA

Addresses

Primary practice location

3701 Skypark Dr
#200
Torrance, CA 90505-4749

Mailing address

3701 Skypark Dr
#200
Torrance, CA 90505-4749
Phone (310) 378-8900

Other identifiers 2

IdentifierTypeStateIssuer
1396724399OtherCACCS PANELED
1396724399MedicaidCA

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
I20060508000754 CA Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists)Practitioner - Sleep Medicine 7810908605 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine, Sleep Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Torrance Health Association IncGroup PAC ID 1355302134, 298 clinicians

Practice addresses (Care Compare)

2841 Lomita Blvd
Suite 235
Torrance, CA 90505-5111
Phone (310) 517-8950

Hospital & facility affiliations

  • Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351
  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201645CAMDCritical Care Medicine (Internal Medicine) Physician
A66752CAMDSleep Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Torrance Health Association Inc CurrentSince Apr 1, 2017 Accepting new patients
Regents of the University of California Pulmonary Disease CurrentSince Mar 8, 2013 Accepting new patients
Torrance Memorial Medical Center Pulmonary Disease Current Accepting new patients
Providence Health System Southern California Past Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients

Locations

File 55737
Los Angeles, CA 90074

514 N Prospect Ave
Fl 4
Redondo Beach, CA 90277
Phone (310) 750-3300

23326 Hawthorne Blvd
Ste 200
Torrance, CA 90505
Phone (310) 257-7205

2841 Lomita Blvd
Ste 235
Torrance, CA 90505
Phone (310) 517-8950

2841 Lomita Blvd
Ste 200
Torrance, CA 90505
Phone (310) 517-8952

3330 Lomita Blvd
Torrance, CA 90505
Phone (310) 517-4675

3701 Skypark Dr
Ste 200
Torrance, CA 90505
Phone (310) 378-8900

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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 3

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368144000000",
    "number": "1396724399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 SKYPARK DR",
            "address_2": "#200",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054749",
            "telephone_number": "310-378-8900",
            "fax_number": "310-791-0786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 SKYPARK DR",
            "address_2": "#200",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054749",
            "telephone_number": "310-378-8900",
            "fax_number": "310-791-0786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELTAWIL",
        "first_name": "KHALID",
        "middle_name": "MOHAMED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2013-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "201645",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "201645",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "201645",
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "CA",
            "license": "A66752",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCS PANELED",
            "identifier": "1396724399",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396724399",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.