Active NPI
Khaled Mohab Zaki, NP
- Geriatric Psychiatry Physician
- Los Altos, CA
National Provider Identifier
1457915969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Psychiatry Physician
- License
- 95137678
- Practice address
- 881 Fremont Ave Ste A5
Los Altos, CA 94024-5637 - Phone
- (650) 469-1360
- NPI assigned
- Apr 30, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 95137678 | CA | |
| Geriatric Psychiatry Physician | 2084P0805X | 95137678 | CA | Primary |
Addresses
Primary practice location
881 Fremont Ave Ste A5
Los Altos, CA 94024-5637
Mailing address
881 Fremont Ave Ste A5
Los Altos, CA 94024-5637
Phone (425) 772-6320
Other practice location 1
13847 E 14th St Ste 205
San Leandro, CA 94578-2626
Phone (510) 924-7667
Other practice location 2
2000 Embarcadero
400
Oakland, CA 94606-5300
Phone (425) 772-6320
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95137678 | CA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719532800000",
"number": "1457915969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "881 FREMONT AVE STE A5",
"city": "LOS ALTOS",
"state": "CA",
"postal_code": "940245637",
"telephone_number": "425-772-6320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "881 FREMONT AVE STE A5",
"city": "LOS ALTOS",
"state": "CA",
"postal_code": "940245637",
"telephone_number": "650-469-1360"
}
],
"practiceLocations": [
{
"address_1": "13847 E 14th St Ste 205",
"address_purpose": "LOCATION",
"city": "San Leandro",
"state": "CA",
"postal_code": "945782626",
"country_code": "US",
"telephone_number": "510-924-7667",
"fax_number": "510-878-7345",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2000 Embarcadero",
"address_2": "400",
"address_purpose": "LOCATION",
"city": "Oakland",
"state": "CA",
"postal_code": "946065300",
"country_code": "US",
"telephone_number": "425-772-6320",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ZAKI",
"first_name": "KHALED",
"middle_name": "MOHAB",
"name_prefix": "Mr.",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-04-30",
"last_updated": "2024-06-28",
"certification_date": "2024-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "95137678",
"primary": false
},
{
"code": "2084P0805X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Geriatric Psychiatry",
"state": "CA",
"license": "95137678",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Altos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.