Hyde Park Medical Group, Inc.

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

A62362 Issued in CA

Legal business name

HYDE PARK MEDICAL GROUP, INC.

Practice address

13950 Milton Ave
Suite 404
Westminster, CA 92683-2900

Phone

(714) 568-1100

Fax

(714) 568-1101

NPI assigned

Feb 12, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Rahil Rashid Khan, M.D.

Title

Owner

Phone

(310) 877-5692

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1360627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360627200000",
    "number": "1770822645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6011 PACIFIC BLVD",
            "address_2": "SUITE 116",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902552951",
            "telephone_number": "714-568-1100",
            "fax_number": "714-568-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13950 MILTON AVE",
            "address_2": "SUITE 404",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926832900",
            "telephone_number": "714-568-1100",
            "fax_number": "714-568-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYDE PARK MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-12",
        "last_updated": "2013-02-12",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "RAHIL",
        "authorized_official_middle_name": "RASHID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-877-5692",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "CA",
            "license": "A62362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Westminster, CA
• Providers in Westminster, CA by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.