Individual provider Active NPI

Ahmed Khan, DO

  • Internal Medicine Physician
  • Long Beach, CA
National Provider Identifier
1609509447
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A22457 Issued in CA
Practice address
2776 Pacific Ave
Long Beach, CA 90806-2613
Phone
(562) 997-2000
NPI assigned
Jul 8, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A22457 CA Primary

Addresses

Primary practice location

2776 Pacific Ave
Long Beach, CA 90806-2613

Mailing address

2776 Pacific Ave
Long Beach, CA 90806-2613
Phone (562) 522-6009

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251112002245 CA Practitioner - Hospitalist 9133610603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

5601 De Soto Ave
Woodland Hills, CA 91367-6701
Phone (818) 719-2000

Hospital & facility affiliations

  • Kaiser Foundation Hospital - Woodland Hills Hospital, Woodland Hills, CA, CCN 050677

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A22457CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 13, 2025 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 13, 2025 Accepting new patients

Locations

888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1657238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1609509447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2776 PACIFIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062613",
            "telephone_number": "562-522-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2776 PACIFIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062613",
            "telephone_number": "562-997-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "AHMED",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-08",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A22457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.