Individual provider Active NPI

Shehzein Khan, DO

  • Family Medicine Physician
  • Newport Beach, CA
National Provider Identifier
1558920132
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19777 Issued in CA
Practice address
1617 Westcliff Dr Ste 207
Newport Beach, CA 92660-5526
Phone
(949) 785-5644
NPI assigned
Jun 7, 2019
Last updated
Sep 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 19777 CA Primary

Addresses

Primary practice location

1617 Westcliff Dr Ste 207
Newport Beach, CA 92660-5526

Mailing address

1617 Westcliff Dr Ste 207
Newport Beach, CA 92660-5526
Phone (949) 785-5644

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220930000753 CA Practitioner - Family Practice 1052797909 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

17251 17TH St
Suite B
Tustin, CA 92780-1963
Phone (657) 241-8580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
19777CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation Family Medicine CurrentSince Mar 6, 2026 Accepting new patients
Regents of the University of California CurrentSince Jul 20, 2022 Accepting new patients
Regents of the University of California CurrentSince Jul 20, 2022 Accepting new patients

Locations

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

3201 Data Dr
Rncho Cordova, CA 95670
Phone (916) 851-1424

3160 Folsom Blvd
Ste 2500
Sacramento, CA 95816
Phone (916) 734-5846

4860 Y St
Ste 200
Sacramento, CA 95817
Phone (916) 734-3761

17251 17th St
Ste B
Tustin, CA 92780
Phone (657) 241-8580

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1558920132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1617 WESTCLIFF DR STE 207",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926605526",
            "telephone_number": "949-785-5644",
            "fax_number": "949-312-6470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 WESTCLIFF DR STE 207",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926605526",
            "telephone_number": "949-785-5644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SHEHZEIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-07",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "19777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.