Individual provider Active NPI

Tarek Ahmed Abou El Kheir, M.D.

  • Obstetrics & Gynecology Physician
  • San Bernardino, CA
National Provider Identifier
1477521789
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
C54454 Issued in CA
Practice address
1800 Western Ave Ste 204
San Bernardino, CA 92411-1353
Phone
(909) 474-9952
Fax
(909) 474-9951
NPI assigned
Mar 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X C54454 CA Primary

Addresses

Primary practice location

1800 Western Ave Ste 204
San Bernardino, CA 92411-1353

Mailing address

1800 Western Ave Ste 204
San Bernardino, CA 92411-1353
Phone (909) 474-9952

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
I20170123001498 CA Practitioner - Obstetrics/Gynecology 7113989575 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C54454CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Central Coast Inc CurrentSince Jan 1, 2017 Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc CurrentSince Jan 1, 2017 Accepting new patients
MCR Health, Inc. Past Accepting new patients

Locations

4723 W Main St
Ste H
Guadalupe, CA 93434
Phone (805) 343-2004

150 Tejas Pl
Nipomo, CA 93444
Phone (805) 929-3254

2050 S Blosser Rd
Santa Maria, CA 93458
Phone (805) 361-8014

1418 E Main St
Ste 210
Santa Maria, CA 93454
Phone (805) 928-3678

210 S Palisade Dr
Ste 102
Santa Maria, CA 93454
Phone (805) 928-7951

2801 Santa Maria Way
Bldg A
Santa Maria, CA 93455
Phone (805) 938-9200

325 Posada Ln
Templeton, CA 93465
Phone (805) 239-0644

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": "1142035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1477521789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 WESTERN AVE STE 204",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924111353",
            "telephone_number": "909-474-9952",
            "fax_number": "909-474-9951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 WESTERN AVE STE 204",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924111353",
            "telephone_number": "909-474-9952",
            "fax_number": "909-474-9951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABOU EL KHEIR",
        "first_name": "TAREK",
        "middle_name": "AHMED",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-11",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "C54454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.