Mustafa A Khatib, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

A92717 Issued in CA

Practice address

742 W Highland Ave
San Bernardino, CA 92405-3839

Phone

(909) 881-7320

Fax

(909) 881-7329

NPI assigned

Dec 29, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Specialty

Obstetrics/Gynecology

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

San Marcos Medical Group IncGroup PAC ID 0749222495, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: mustafa.khatib.p1@direct.metro.nextgenshare.com

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.

• San Marcos Medical Group Inc

  dba Summit Family Health Center

  • Obstetrics & Gynecology Physician
  • Fontana, CA
  • NPI 1447446448
  Medicare reassignment Care Compare group NPD
• San Marcos Medical Group Inc.

  dba metropolitan family medical clinic

  • Family Nurse Practitioner
  • San Bernardino, CA
  • NPI 1184674830
  NPD (past)
• San Marcos Medical Group Inc.

  dba metropolitan family medical clinic

  • Family Medicine Physician
  • San Bernardino, CA
  • NPI 1548210297
  NPD (past)
• San Marcos Medical Group Inc.

  dba Metropolitan Fammily Medical Clinic

  • Family Medicine Physician
  • Fontana, CA
  • NPI 1639129372
  NPD (past)
• San Marcos Medical Group Inc.

  dba metropolitan family medical clinic inc.

  • Family Medicine Physician
  • Riverside, CA
  • NPI 1952351686
  NPD (past)

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588720858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 W HIGHLAND AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924053839",
            "telephone_number": "909-881-7320",
            "fax_number": "909-881-7329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "742 W HIGHLAND AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924053839",
            "telephone_number": "909-881-7320",
            "fax_number": "909-881-7329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHATIB",
        "first_name": "MUSTAFA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A92717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A92717",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kha Dang Le and Anne Hangman Le DMD Inc
• Laiba Khan
• Munir Khan
• Ankita Khanna
• Mohammed Amir Khasru, D.D.S.
• Nadir O Khattab, DDS
• Omar Khayat, MD
• Ali Khazaei Nezhad, M.D.
• Rawan Kheir, PT, MPT
• Sylvia M Khoury, PHARMD

• Obstetrics & Gynecology Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.