NPIMap

Individual provider Active NPI

Khaled Al Tawil

  • Diagnostic Radiology Physician
  • San Diego, CA
National Provider Identifier
1407319684
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A201335 Issued in CA
Practice address
8745 Aero Dr Ste 200
San Diego, CA 92123-1774
Phone
(858) 565-0950
NPI assigned
Apr 13, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A201335 CA Primary

Addresses

Primary practice location

8745 Aero Dr Ste 200
San Diego, CA 92123-1774

Mailing address

PO Box 60604
City of Industry, CA 91716-0604

Other practice location 1

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 725-2181

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
I20250722002783 CA Practitioner - Diagnostic Radiology 9234645664 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Vermont College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Diego Imaging-Chula Vista LLC 43 clinicians
San Diego Diagnostic Radiology Medical Group Inc 47 clinicians

Practice addresses (Care Compare)

765 Medical Ctr CT
Chula Vista, CA 91911-6600
Phone (619) 397-6577

7901 Frost St
San Diego, CA 92123-2701
Phone (858) 939-3600

Hospital & facility affiliations

  • Sharp Memorial Hospital Hospital, San Diego, CA, CCN 050100
  • Sharp Chula Vista Medical Center Hospital, Chula Vista, CA, CCN 050222
  • Sharp Coronado Hospital and Hlthcr Ctr Hospital, Coronado, CA, CCN 050234
  • Grossmont Hospital Hospital, La Mesa, CA, CCN 050026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A201335CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Diego Diagonstic Radiology Medical Group, Inc. Diagnostic Radiology CurrentSince Jul 21, 2025 Accepting new patients
San Diego Diagnostic Radiology Medical Group, Inc. Current Accepting new patients
San Diego Imaging, LLC Current Accepting new patients
San Diego Diagnostic Radiology Medical Group, Inc. Diagnostic Radiology CurrentSince Jul 21, 2025 Accepting new patients
San Diego Diagnostic Radiology Medical Group Inc Diagnostic Radiology Current Accepting new patients
San Diego Imaging-Chula Vista LLC CurrentSince Jul 21, 2025 Accepting new patients

Locations

765 Medical Center Ct
Chula Vista, CA 91911
Phone (619) 397-6577

751 Medical Center Ct
Chula Vista, CA 91911
Phone (619) 482-3639

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

250 Prospect Pl
San Diego, CA 92118
Phone (619) 522-3600

3075 Health Center Dr
San Diego, CA 92123
Phone (858) 637-7888

7910 Frost St
Ste 100
San Diego, CA 92123
Phone (858) 634-5900

8745 Aero Dr
Ste 200
San Diego, CA 92123

Organizations & group practices 6

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 5

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": "1555113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1407319684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60604",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917160604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8745 AERO DR STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231774",
            "telephone_number": "858-565-0950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Pasteur Dr",
            "address_purpose": "LOCATION",
            "city": "Stanford",
            "state": "CA",
            "postal_code": "943052200",
            "country_code": "US",
            "telephone_number": "650-725-2181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL TAWIL",
        "first_name": "KHALED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-13",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A201335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.