Nazifah Khairullah, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

C142450 Issued in CA

Practice address

2055 Lincoln Ave
Pasadena, CA 91103-1324

Phone

(626) 488-8728

NPI assigned

Aug 17, 2005

Last updated

Dec 27, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482796800000",
    "number": "1659363562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3054 HOPETON RD",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912141324",
            "telephone_number": "917-513-4340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 LINCOLN AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911031324",
            "telephone_number": "626-488-8728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAIRULLAH",
        "first_name": "NAZIFAH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-17",
        "last_updated": "2016-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA07450100",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C142450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8971307",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Kevin Khachatryan, DDS
• Marine Khachatryan, MD
• Steve Khachi, M.D.
• Hermine Khachikyan
• Steve Khachikyan
• Khajadour Donabedian D.D.S.. Inc
• Khajadour Donabedian DDS Inc (Foothill Dental Group)
• Sally Khakshooy, MPH
• John Patrick Khalaf, DDS
• Ramin Nmi Khalili, MD FACS

• Pediatrics Physician in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.