NPIMap

Individual provider Active NPI

Farhan Khabaz, MD

  • Pulmonary Disease Physician
  • Fullerton, CA
National Provider Identifier
1427159458
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
A69690 Issued in CA
Practice address
101 E Valencia Mesa Dr
Fullerton, CA 92835-3809
Phone
(714) 871-3280
Fax
(714) 707-4238
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A69690 CA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X A69690 CA
Pulmonary Disease Physician 207RP1001X A69690 CA Primary

Addresses

Primary practice location

101 E Valencia Mesa Dr
Fullerton, CA 92835-3809

Mailing address

15642 Sand Canyon Ave Unit 54508
Irvine, CA 92619-5454
Phone (714) 519-1537

Other practice location 1

2141 N Harbor Blvd Ste 25000
Fullerton, CA 92835-3830
Phone (714) 626-8650

Other identifiers 1

IdentifierTypeStateIssuer
A69690OtherCAMEDICAL LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address farhankhabaz@sjhhandhmg.allscriptsdirect.net

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
I20040814000271 CA Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Hospice/Palliative CarePractitioner - Critical Care (Intensivists) 8123091568 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Hospice/Palliative Care, Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

100 E Valencia Mesa Dr
Suite 105
Fullerton, CA 92835-3816
Phone (714) 871-3006

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

875 N Brea Blvd
Brea, CA 92821-2606
Phone (714) 519-1537

Hospital & facility affiliations

  • Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168
  • Uci Health-Orange Hospital, Orange, CA, CCN 050348
  • Kindred Hospital Brea Long-term care hospital, Brea, CA, CCN 052039
  • Kindred Hospital Brea D/P SNF Nursing home, Brea, CA, CCN 555859

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69690CAMDPharmacist
A69690CAMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Nov 1, 2007 Accepting new patients
Farhan Khabaz MD Professional Corp Pulmonary Disease CurrentSince Oct 17, 2016 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Medical Urgent Care, LLC PastSince Dec 1, 2005 Accepting new patients
Pulmonary Medicine of Dayton Inc. Internal Medicine PastSince Feb 1, 1994 Accepting new patients
Our Lady of Mercy Medical Center Past Accepting new patients

Locations

875 N Brea Blvd
Brea, CA 92821
Phone (714) 529-6842

101 E Valencia Mesa Dr
Fullerton, CA 92835
Phone (714) 446-7505

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

2141 N Harbor Blvd
Ste 25000
Fullerton, CA 92835
Phone (714) 626-8610

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

15642 Sand Canyon Ave
Unit 54508
Irvine, CA 92619
Phone (714) 772-8282

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Kindred Hospital BreaBrea, CA, CCN 555859 Skilled nursing facility Managing Control - Governing Body
Adp of the SNF		 Mar 17, 2025
Mar 17, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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 7

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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1427159458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15642 SAND CANYON AVE UNIT 54508",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926195454",
            "telephone_number": "714-519-1537",
            "fax_number": "714-519-1537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E VALENCIA MESA DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353809",
            "telephone_number": "714-871-3280",
            "fax_number": "714-707-4238"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2141 N Harbor Blvd Ste 25000",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928353830",
            "country_code": "US",
            "telephone_number": "714-626-8650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHABAZ",
        "first_name": "FARHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A69690",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "A69690",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A69690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A69690",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "farhankhabaz@sjhhandhmg.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "2141 N Harbor Blvd Ste 25000",
            "city": "Fullerton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928353830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.