Individual provider Active NPI

Khae V Saephanh, D.O.

  • Family Medicine Physician
  • San Jose, CA
National Provider Identifier
1669588133
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A9049 Issued in CA
Practice address
2150 N 1St St FL 2
San Jose, CA 95131-2020
Phone
(888) 663-6331
Fax
(415) 252-7176
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A9049 CA Primary

Addresses

Primary practice location

2150 N 1St St FL 2
San Jose, CA 95131-2020

Mailing address

130 Sutter St FL 2
San Francisco, CA 94104-4009
Phone (415) 658-6791

Other practice location 1

746 The Alameda
San Jose, CA 95126-3154
Phone (408) 228-1020

Other identifiers 3

IdentifierTypeStateIssuer
20A9049OtherCAMEDICAL LICENSE
00AX90490MedicaidCA
20A9049OtherCALICENSE

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060908000513 CA Practitioner - Family Practice 8426052291 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
One Medical Group IncGroup PAC ID 2567623739, 330 clinicians

Practice addresses (Care Compare)

559 Clay St
Suite 200
San Francisco, CA 94111-3029
Phone (888) 663-6331

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A9049CAMDFamily Medicine Physician
9049CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
One Medical Group, Inc. Family Medicine CurrentSince Jan 18, 2016 Accepting new patients
One Medical Group, Inc Family Medicine CurrentSince Jan 18, 2016 Accepting new patients
North East Medical Services CurrentSince Nov 4, 2013 Accepting new patients
North East Medical Services Current Accepting new patients

Locations

211 Eastmoor Ave
Daly City, CA 94015
Phone (650) 550-3923

1955 Broadway
Ste A
Oakland, CA 94612

900 Veterans Blvd
Ste 150
Redwood City, CA 94063
Phone (650) 298-8774

110 Sutter St
Fl 6
San Francisco, CA 94104
Phone (415) 392-8200

559 Clay St
#200
San Francisco, CA 94111
Phone (415) 830-4744

130 Sutter St
Fl 2
San Francisco, CA 94104
Phone (415) 529-4522

1 Embarcadero Ctr
Ste 1900
San Francisco, CA 94111

82 Leland Ave
San Francisco, CA 94134
Phone (415) 391-9688

2150 N 1st St
Fl 2
San Jose, CA 95131

746 The Alameda
San Jose, CA 95126
Phone (408) 228-1020

1870 Lundy Ave
San Jose, CA 95131
Phone (408) 573-9686

2150 N 1st St
Ste 250
San Jose, CA 95131
Phone (408) 228-1022

2950 S Delaware St
Ste 150
San Mateo, CA 94403

1004 Northgate Dr
San Rafael, CA 94903
Phone (415) 590-6150

1299 Oakmead Pkwy
Sunnyvale, CA 94085
Phone (408) 266-3100

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1669588133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 SUTTER ST FL 2",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941044009",
            "telephone_number": "415-658-6791",
            "fax_number": "415-520-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 N 1ST ST FL 2",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951312020",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "746 The Alameda",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951263154",
            "country_code": "US",
            "telephone_number": "408-228-1020",
            "fax_number": "415-252-7176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAEPHANH",
        "first_name": "KHAE",
        "middle_name": "V",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A9049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "20A9049",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX90490",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "20A9049",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.