S M Khandhar DO a Professional Medical Corporation

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

Legal business name

S M KHANDHAR DO A PROFESSIONAL MEDICAL CORPORATION

Practice address

1820 Fullerton Ave Ste 125
Corona, CA 92881-3160

Phone

(650) 954-5542

NPI assigned

Oct 30, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Sumit M Khandhar, DO

Title

Medical Director

Phone

(650) 954-5542

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572393600000",
    "number": "1457995789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 FULLERTON AVE STE 125",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928813160",
            "telephone_number": "650-954-5542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 FULLERTON AVE STE 125",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928813160",
            "telephone_number": "650-954-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S M KHANDHAR DO A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-30",
        "last_updated": "2019-10-30",
        "status": "A",
        "authorized_official_last_name": "KHANDHAR",
        "authorized_official_first_name": "SUMIT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "650-954-5542",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "20A10557",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Josefine Ruvalcaba
• Abbigail Grace Ruzicka
• Brett Ryan
• Scott M Ryder, MA
• S & G Chiropractic Group
• Shady Tarek Youssef Saad, RPH.
• Ali Saadani
• Vida Saatsaz, RDN
• Antoine Saba
• King Nicolai Sabado

• Interventional Cardiology Physician in Corona, CA
• Providers in Corona, CA by specialty
• Interventional Cardiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.