Active NPI
Mehri Khatibi, M.D.
- Gynecology Physician
- Modesto, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- A 113691
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 113691 | CA | MD | Marriage & Family Therapist |
| A 113691 | CA | MD | Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hoag Clinic | Current | Accepting new patients | |
| Magella Medical Group, Inc. | Current | Accepting new patients | |
| Obhg California, P.C. | Current | 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
- https://api.platform.athenahealth.com/10944/brand/3/csg/1/fhir/r4
- 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.
-
- Primary Care Clinic/Center
- Newport Beach, CA
- NPI 1942799523
-
- Maternal & Fetal Medicine Physician
- Long Beach, CA
- NPI 1376640086
-
- Federally Qualified Health Center (FQHC)
- Ontario, CA
- NPI 1003546342
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; 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.