Kanan Modi MD Inc

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

KANAN MODI MD INC

Practice address

1305 W Arrow Hwy Ste 104
San Dimas, CA 91773-2337

Phone

(909) 394-9004

Fax

(909) 394-9461

NPI assigned

Aug 27, 2013

Organization subpart

No

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

Authorized official

Name

Kanan Modi, MDNPI 1881704898

Title

Owner

Phone

(909) 394-9004

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kanan Modi, M.D.

  • Pediatrics Physician
  • San Dimas, CA
  • NPI 1881704898
  Authorized official Same address or phone

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377561600000",
    "number": "1700210762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 W ARROW HWY STE 104",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732337",
            "telephone_number": "909-394-9004",
            "fax_number": "909-394-9461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 W ARROW HWY STE 104",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732337",
            "telephone_number": "909-394-9004",
            "fax_number": "909-394-9461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANAN MODI MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-27",
        "last_updated": "2013-08-27",
        "status": "A",
        "authorized_official_last_name": "MODI",
        "authorized_official_first_name": "KANAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-394-9004",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881704898",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sabah Kadhium, MD
• Ritika Ravijit Kahandal, M.S. CCC-SLP
• Kaiser Foundation Health Plan Inc (Kaiser Permanente Pharmacy #553)
• Nader Kalantar, M.D.
• Fari Garzam Kamalpour, D.O.
• Glenn I Kane, MD
• Yuelin Kang
• Jun Wei Kao
• Tamarah Karahbi
• Karim Magid Zaklama Dental Corporation (Dentists of San Dimas)

• Pediatrics Physician in San Dimas, CA
• Providers in San Dimas, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.