Individual provider Active NPI

Sonia Fareeda Khan, MD

  • Pediatric Adolescent Medicine Physician
  • Fremont, CA
National Provider Identifier
1801056700
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
A049044 Issued in CA
Practice address
39155 Liberty St Ste E500
Fremont, CA 94538-1516
Phone
(510) 378-3036
NPI assigned
Jun 13, 2008
Last updated
Dec 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A049044 CA
Pediatric Critical Care Medicine Physician 2080P0203X A049044 CA
Pediatric Adolescent Medicine Physician 2080A0000X A049044 CA Primary

Addresses

Primary practice location

39155 Liberty St Ste E500
Fremont, CA 94538-1516

Mailing address

39120 Argonaut Way
#363
Fremont, CA 94538-1304
Phone (510) 378-3036

Other practice location 1

39120 Argonaut Way
#363
Fremont, CA 94538-1304
Phone (510) 378-3036

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A049044CAMDPediatric Adolescent Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1213315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1801056700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39120 ARGONAUT WAY",
            "address_2": "#363",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381304",
            "telephone_number": "510-378-3036",
            "fax_number": "510-793-9216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39155 LIBERTY ST STE E500",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381516",
            "telephone_number": "510-378-3036"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39120 Argonaut Way",
            "address_2": "#363",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "CA",
            "postal_code": "945381304",
            "country_code": "US",
            "telephone_number": "510-378-3036",
            "fax_number": "510-793-9216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SONIA",
        "middle_name": "FAREEDA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-13",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A049044",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CA",
            "license": "A049044",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CA",
            "license": "A049044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; 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.