Active NPI
Shahid M Khan, MD
- Internal Medicine Physician
- Northridge, CA
National Provider Identifier
1770518771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A49009
- Practice address
- 17075 Devonshire St
#101
Northridge, CA 91325-1600 - Phone
- (818) 357-2262
- Fax
- (818) 357-2270
- NPI assigned
- Jul 11, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A49009 | CA | Primary |
Addresses
Primary practice location
17075 Devonshire St
#101
Northridge, CA 91325-1600
Mailing address
17075 Devonshire St
#101
Northridge, CA 91325-1600
Phone (818) 357-2262
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A490090 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A49009 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Healthcare Inc. | Internal Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Northridge, CA
- NPI 1427221613
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770518771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17075 DEVONSHIRE ST",
"address_2": "#101",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913251600",
"telephone_number": "818-357-2262",
"fax_number": "818-357-2270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17075 DEVONSHIRE ST",
"address_2": "#101",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913251600",
"telephone_number": "818-357-2262",
"fax_number": "818-357-2270"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "SHAHID",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A49009",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A490090",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Northridge, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.