Organization Active NPI

Ayaz O Khan Inc

  • Ophthalmology Physician
  • Pomona, CA
National Provider Identifier
1558720516
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
20A9417 Issued in CA
Legal business name
AYAZ O KHAN INC
Practice address
648 N Park Ave
Pomona, CA 91768-3621
Phone
(909) 927-8487
Fax
(844) 431-4730
NPI assigned
Feb 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Authorized official

Name
Ayaz O Khan, DONPI 1467617159
Title
Ceo
Phone
(626) 376-8463

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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 20A9417 CA Primary

Addresses

Primary practice location

648 N Park Ave
Pomona, CA 91768-3621

Mailing address

2035 Calle Francesca
San Dimas, CA 91773-4457

Other practice location 1

2035 Calle Francesca
San Dimas, CA 91773-4457
Phone (626) 376-8463

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161005002827 CA Part B Supplier - Clinic/Group Practice 4880982941 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA; San Bernardino, CA; Riverside, CA; Redlands, CA; Pomona, CA; Oakland, CA; San Pablo, CA; San Rafael, CA…

National Provider Directory

National Provider Directory

Locations

350 Calloway Dr
Unit C1
Bakersfield, CA 93312
Phone (661) 587-0182

13768 Roswell Ave
Ste 208
Chino, CA 91710
Phone (909) 576-7576

8487 Magnolia Ave
Riverside, CA 92504
Phone (805) 485-3338

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1455753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652832000000",
    "number": "1558720516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 CALLE FRANCESCA",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917734457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 N PARK AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917683621",
            "telephone_number": "909-927-8487",
            "fax_number": "844-431-4730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2035 Calle Francesca",
            "address_purpose": "LOCATION",
            "city": "San Dimas",
            "state": "CA",
            "postal_code": "917734457",
            "country_code": "US",
            "telephone_number": "626-376-8463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AYAZ O KHAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-18",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "AYAZ",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-376-8463",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "20A9417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.