Active NPI
Brandon B Khaw, MD
- Internal Medicine Physician
- Fountain Valley, CA
National Provider Identifier
1568453637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A44393
- Practice address
- 11420 Warner Ave
Fountain Valley, CA 92708-2529 - Phone
- (714) 549-1300
- Fax
- (714) 433-3100
- NPI assigned
- Oct 28, 2005
- Last updated
- Mar 31, 2011
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A44393 | CA | Primary |
Addresses
Primary practice location
11420 Warner Ave
Fountain Valley, CA 92708-2529
Mailing address
2742 Dow Ave
Tustin, CA 92780-7242
Phone (714) 665-1600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A443930 | 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 CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 87.17 of 100
- Quality
- 81.15
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.64
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A44393 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorialcare Medical Foundation | Internal Medicine | Current | Accepting new patients |
Locations
722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300
11420 Warner Ave
Fountain Vly, CA 92708
Phone (714) 549-1300
2742 Dow Ave
Tustin, CA 92780
Phone (714) 665-1600
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301529600000",
"number": "1568453637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2742 DOW AVE",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927807242",
"telephone_number": "714-665-1600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11420 WARNER AVE",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927082529",
"telephone_number": "714-549-1300",
"fax_number": "714-433-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAW",
"first_name": "BRANDON",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-28",
"last_updated": "2011-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A44393",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A443930",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fountain Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2011; 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.