Organization Active NPI

Abid Hameed Khan MD Professional Corporation

  • Nephrology Physician
  • Ontario, CA
National Provider Identifier
1518153733
Registry record updated Mar 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 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
Last updated
Mar 26, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2015

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

Authorized official

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

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081216000471 CA Part B Supplier - Clinic/Group Practice 1355403981 Receives reassigned benefits from 4 practitioners
Practice locations: Ontario, CA; Pomona, CA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2009510Abid H Khan, MD Professional Corp1001 West Sixth St, Ontario, CA 91762Certificate of waiverDec 3, 2027

National Provider Directory

National Provider Directory

Locations

1001 W 6th St
Ste C
Ontario, CA 91762

2475 N Garey Ave
Pomona, CA 91767
Phone (909) 596-9997

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427328000000",
    "number": "1518153733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2229 N 2ND AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917841397",
            "telephone_number": "909-984-0313",
            "fax_number": "909-984-0319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 W. SIXTH STREET",
            "address_2": "SUITE A",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "91762",
            "telephone_number": "909-984-0313",
            "fax_number": "909-984-0319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABID HAMEED KHAN MD PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2015-03-26",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "ABID",
        "authorized_official_middle_name": "HAMEED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-984-0313",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.