Khaingthazin San, MD

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

A167089 Issued in CA

Practice address

2601 Ocean Pkwy
Brooklyn, NY 11235-7745

Phone

(718) 616-3000

NPI assigned

Jun 28, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Internal MedicineAlso: Endocrinology

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Golden Valley Health CentersGroup PAC ID 4183527187, 114 clinicians

Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 31)

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.

• Golden Valley Health Centers

  • Federally Qualified Health Center (FQHC)
  • Turlock, CA
  • NPI 1356445753

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Westley, CA
  • NPI 1770568347

  Multi-Specialty

  NPD
• Golden Valley Health Centers

  • Community/Retail Pharmacy
  • Merced, CA
  • NPI 1093817405
  NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510

  Multi-Specialty

  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1508387630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7373 WEST LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952103377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 OCEAN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112357745",
            "telephone_number": "718-616-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1545 Atlantic Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112131122",
            "country_code": "US",
            "telephone_number": "171-861-3400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAN",
        "first_name": "KHAINGTHAZIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-28",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A167089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "7373 West Ln",
            "city": "Stockton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "952103377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Angela Lopez San Jose, PT
• Hannah Marie Cruz San Jose, OTR/L
• San RX Inc
• San San Wynn, M.D., P.C.
• Htet San, MD
• Mon Mon Myint San, M.D.,
• Myat San, M.D.
• Sana Family Dentistry
• Sana G ABA Corp
• Sana Pharmacy Inc

• Endocrinology, Diabetes & Metabolism Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Endocrinology, Diabetes & Metabolism Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.