NPIMap

Individual provider Active NPI

Sherif Zaki Khamis, M.D

  • Pediatrics Physician
  • Canoga Park, CA
National Provider Identifier
1467476598
Registry record updated Sep 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A43370 Issued in CA
Practice address
7111 Winnetka Ave
Suite # 14
Canoga Park, CA 91306-3646
Phone
(818) 347-0065
Fax
(818) 587-3687
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A43370 CA Primary

Addresses

Primary practice location

7111 Winnetka Ave
Suite # 14
Canoga Park, CA 91306-3646

Mailing address

7111 Winnetka Ave
Suite # 14
Canoga Park, CA 91306-3646
Phone (818) 347-0065

Other identifiers 2

IdentifierTypeStateIssuer
00A433740MedicaidCA
010723640OtherCACORPORATION

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A43370CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tarzana Medical Center LLC Past Accepting new patients
Healthcare Partners Affiliates Medical Group Past Accepting new patients
Dignity Community Care Past Accepting new patients
Palmdale Pediatric Center Inc Past Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients
Valley Presbyterian Hospital Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189555200000",
    "number": "1467476598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7111 WINNETKA AVE",
            "address_2": "SUITE # 14",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913063646",
            "telephone_number": "818-347-0065",
            "fax_number": "818-587-3687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7111 WINNETKA AVE",
            "address_2": "SUITE # 14",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913063646",
            "telephone_number": "818-347-0065",
            "fax_number": "818-587-3687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAMIS",
        "first_name": "SHERIF",
        "middle_name": "ZAKI",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A43370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A433740",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATION",
            "identifier": "010723640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canoga Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; 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.