Active NPI
Paul A Khavari, MD
- Dermatology Physician
- Stanford, CA
National Provider Identifier
1780696252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- G69476
- Practice address
- 300 Pasteur Dr
Stanford, CA 94305-2200 - Phone
- (650) 723-4000
- NPI assigned
- Aug 13, 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 |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | G69476 | CA | Primary |
Addresses
Primary practice location
300 Pasteur Dr
Stanford, CA 94305-2200
Mailing address
269 Campus Dr
CCSR 2155
Stanford, CA 94305-5101
Other practice location 1
269 Campus Dr
CCSR 2155
Stanford, CA 94305-5101
Phone (650) 852-3494
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 |
|---|---|---|---|
| G69476 | CA | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stanford Health Care | Dermatology | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713225600000",
"number": "1780696252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "269 CAMPUS DR",
"address_2": "CCSR 2155",
"city": "STANFORD",
"state": "CA",
"postal_code": "943055101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 PASTEUR DR",
"city": "STANFORD",
"state": "CA",
"postal_code": "943052200",
"telephone_number": "650-723-4000"
}
],
"practiceLocations": [
{
"address_1": "269 Campus Dr",
"address_2": "CCSR 2155",
"address_purpose": "LOCATION",
"city": "Stanford",
"state": "CA",
"postal_code": "943055101",
"country_code": "US",
"telephone_number": "650-852-3494",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KHAVARI",
"first_name": "PAUL",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-13",
"last_updated": "2024-04-16",
"certification_date": "2024-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "G69476",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stanford, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.