Active NPI
Alam Khan, MD
- Anesthesiology Physician
- Marysville, CA
National Provider Identifier
1568403194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- G79534
- Practice address
- 726 4TH St
Marysville, CA 95901-5656 - Phone
- (530) 749-4300
- NPI assigned
- Jun 8, 2006
- Last updated
- Apr 13, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | G79534 | CA | Primary |
Addresses
Primary practice location
726 4TH St
Marysville, CA 95901-5656
Mailing address
PO Box 7096
Stockton, CA 95267-0096
Phone (209) 956-7725
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G795340 | Medicaid | CA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- University of California, Davis School of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3315 Watt Ave
Sacramento, CA 95821-3600
Phone 91648168001234
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 79534 | CA | MD | Pharmacist |
| G79534 | CA | MD | Anesthesiology Physician |
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Sacramento, CA
- NPI 1720401284
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428883200000",
"number": "1568403194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7096",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952670096",
"telephone_number": "209-956-7725",
"fax_number": "209-956-7733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "726 4TH ST",
"city": "MARYSVILLE",
"state": "CA",
"postal_code": "959015656",
"telephone_number": "530-749-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "ALAM",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-08",
"last_updated": "2015-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "G79534",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G795340",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marysville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; 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.
- 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.