Issam N Khafaja, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A54280 Issued in CA

Practice address

777 Flower St
Ste a
Glendale, CA 91201-3000

Phone

(818) 552-6230

Fax

(818) 888-7018

NPI assigned

Jun 1, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: issamkhafaja@hcpca.allscriptsdirect.net

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.

• Healthcare Partners Affiliates Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593

  CA

  Medicare reassignment
• Nueva Vida Medical Inc.

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1316017809
  NPD (past) Authorized official
• Carbon Health Medical Group of California PC

  • Urgent Care Clinic/Center
  • Berkeley, CA
  • NPI 1417294232
  NPD (past)
• Dignity Community Care

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1114081056
  NPD (past)
• Lakeside Medical Associates, a Medical Group, Inc.

  • Hospitalist Physician
  • Glendale, CA
  • NPI 1932129434

  Internal Medicine

  NPD (past)
• Lakeside Medical Organization, a Medical Group Inc.

  • Internal Medicine Physician
  • West Hills, CA
  • NPI 1831426642

  Internal Medicine

  NPD (past)
• Memorial Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Phoenix, AZ
  • NPI 1255523643
  NPD (past)

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383609600000",
    "number": "1528062874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 FLOWER ST",
            "address_2": "STE A",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912013000",
            "telephone_number": "818-637-2000",
            "fax_number": "818-888-7018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 FLOWER ST",
            "address_2": "STE A",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912013000",
            "telephone_number": "818-552-6230",
            "fax_number": "818-888-7018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAFAJA",
        "first_name": "ISSAM",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2013-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A54280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A542800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Khachikyan, FNP
• Emma Khachikyan, OWNER
• Lusine Khachikyan
• Sela Khachikyan
• Vahe Khachikyan
• Leea Khaioian
• Mana Khajavi
• Talin Khajavi
• Bina Khaki, AMFT
• Anahit N. Khalafyan

• All providers in Glendale, CA
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.