Individual provider Active NPI

Imanuel Khalili, M.D.

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1447546627
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A128772 Issued in CA
Practice address
1046 S Robertson Blvd
Los Angeles, CA 90035-1505
Phone
(424) 355-0301
Fax
(216) 208-1348
NPI assigned
Jun 25, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A128772 CA Primary

Addresses

Primary practice location

1046 S Robertson Blvd
Los Angeles, CA 90035-1505

Mailing address

1046 S Robertson Blvd
Los Angeles, CA 90035-1505
Phone (424) 355-0301

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20140909002873 CA Practitioner - Internal Medicine 4385863109 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

6041 Cadillac Ave
Los Angeles, CA 90034-1702
Phone (800) 954-8000

9029 W Pico Blvd
Los Angeles, CA 90035-1309
Phone (424) 355-0301

Hospital & facility affiliations

  • Aino Home Health, Inc Home health agency, Northridge, CA, CCN 559010
  • Diamond Home Health, Inc Home health agency, Tarzana, CA, CCN 059281
  • Presidential Home Health, Inc Home health agency, Woodland Hills, CA, CCN 559304
  • Medprof Home Health Care, Inc Home health agency, Studio City, CA, CCN 559365
  • High Quality Care for All, Inc. Home health agency, Los Angeles, CA, CCN 757241
  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A128772CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Jun 28, 2017 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jun 28, 2017 Accepting new patients
Imanuel Khalili M.D.., Inc CurrentSince Sep 18, 2015 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
SRM Alliance Hospital Services PastSince May 1, 2020 Accepting new patients

Locations

1270 S Alfred St
Unit 352338
Los Angeles, CA 90035

1046 S Robertson Blvd
Los Angeles, CA 90035
Phone (424) 355-0301

9029 W Pico Blvd
Los Angeles, CA 90035
Phone (424) 355-0301

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

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 6

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": "1308960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1447546627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1046 S ROBERTSON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351505",
            "telephone_number": "424-355-0301",
            "fax_number": "216-208-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 S ROBERTSON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351505",
            "telephone_number": "424-355-0301",
            "fax_number": "216-208-1348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALILI",
        "first_name": "IMANUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-25",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A128772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.