Abid Hameed Khan MD Professional Corporation

Key facts

NPI: 1518153733
Entity type: Organization (NPI type 2)
Primary specialty: Nephrology Physician 207RN0300X
Legal business name: ABID HAMEED KHAN MD PROFESSIONAL CORPORATION
Practice address: 1001 W. Sixth Street
Suite a
Ontario, CA 91762
Phone: (909) 984-0313
Fax: (909) 984-0319
NPI assigned: Sep 20, 2007
Organization subpart: No

Authorized official

Name: Abid Hameed Khan, M.D. NPI 1326184524
Title: President
Phone: (909) 984-0313

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Abid H Khan, M.D. Nephrology Physician · Ontario, CA · NPI 1326184524

Medicare reassignment NPD Authorized official CA · NEPHROLOGY
Amir Kashefi, M.D. Vascular & Interventional Radiology Physician · Pasadena, CA · NPI 1558591933

Medicare reassignment NPD CA
Michael Aaron Lalezarian Vascular & Interventional Radiology Physician · Los Angeles, CA · NPI 1023245230

Medicare reassignment NPD CA
Omar Saleh, M.D. Vascular & Interventional Radiology Physician · Corona, CA · NPI 1124280375

Medicare reassignment NPD CA
Khalid Saleh Vascular & Interventional Radiology Physician · Corona, CA · NPI 1689015273

NPD (past)

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
05D2009510	Abid H Khan, MD Professional Corp 1001 West Sixth St, Ontario, CA 91762	Certificate of waiver	Dec 3, 2027

Medicare participation

Medicare fee-for-service enrollment: Enrolled in CA

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20081216000471	CA	Part B Supplier - Clinic/Group Practice	1355403981	Receives reassigned benefits from 4 practitioners Practice locations: Ontario, CA; Pomona, CA

National Provider Directory

Locations

1001 W 6th St
Ontario, CA 91762
Phone (909) 984-0313

1001 W 6th St
Ste C
Ontario, CA 91762

1001 W 6th St
Ste A
Ontario, CA 91762
Phone (909) 816-6258

2850 N Garey Ave
Pomona, CA 91767
Phone (909) 399-5500

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Nephrology Physician Group: 193400000X SINGLE SPECIALTY GROUP	207RN0300X			Yes

Addresses

Primary practice location

1001 W. Sixth Street
Suite a
Ontario, CA 91762

Mailing address

2229 N 2ND Ave
Upland, CA 91784-1397
Phone (909) 984-0313

Other providers in Ontario, CA

All providers in Ontario, CA · Nephrology Physician in California

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 26, 2015. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (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.