Individual provider Active NPI

Mehri Khatibi, M.D.

  • Gynecology Physician
  • Modesto, CA
National Provider Identifier
1730380718
Registry record updated Nov 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
A 113691 Issued in CA
Practice address
200 W Coolidge Ave
Modesto, CA 95350-4447
Phone
(209) 577-5005
Fax
(209) 521-1533
NPI assigned
May 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X A 113691 CA Primary

Addresses

Primary practice location

200 W Coolidge Ave
Modesto, CA 95350-4447

Mailing address

200 W Coolidge Ave
Modesto, CA 95350-4447
Phone (209) 577-5005

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
I20110221000757 CA Practitioner - Obstetrics/Gynecology 5496936650 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
113691CAMDMarriage & Family Therapist
A 113691CAMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hoag Clinic CurrentSince Mar 17, 2024 Accepting new patients
Magella Medical Group, Inc. CurrentSince Sep 30, 2017 Accepting new patients
Obhg California, P.C. CurrentSince Apr 1, 2024 Accepting new patients
Friends of Family Health Center Past Accepting new patients

Locations

17100 Euclid St
Fountain Vly, CA 92708
Phone (714) 966-7200

2865 Atlantic Ave
Ste 110
Long Beach, CA 90806
Phone (562) 933-0590

4281 Katella Ave
Ste 223
Los Alamitos, CA 90720
Phone (562) 429-7100

File 50978
Los Angeles, CA 90074

1 Hoag Dr
Ste 107
Newport Beach, CA 92663
Phone (949) 764-5347

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

39000 Bob Hope Dr
Rancho Mirage, CA 92270
Phone (760) 340-3911

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

1031 Avenida Pico
Ste 204
San Clemente, CA 92673
Phone (949) 829-5533

4101 Torrance Blvd
Torrance, CA 90503
Phone (310) 540-7676

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10944/brand/3/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291075200000",
    "number": "1730380718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W COOLIDGE AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504447",
            "telephone_number": "209-577-5005",
            "fax_number": "209-521-1533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W COOLIDGE AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504447",
            "telephone_number": "209-577-5005",
            "fax_number": "209-521-1533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHATIBI",
        "first_name": "MEHRI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2010-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": "A 113691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.