NPIMap

Organization Active NPI

Morris Kokhab, M.D., a Medical Corporation

  • Medical Specialty Clinic/Center
  • Upland, CA
National Provider Identifier
1821271420
Registry record updated Aug 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
A75850 Issued in CA
Legal business name
MORRIS KOKHAB, M.D., A MEDICAL CORPORATION
Practice address
974 W Foothill Blvd
Upland, CA 91786-3728
Phone
(909) 932-1122
Fax
(909) 932-9292
NPI assigned
Dec 6, 2007
Last updated
Aug 13, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2015

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

Authorized official

Name
Prof. Morris Kokhab, M.D.NPI 1245248681
Title
President
Phone
(909) 932-1122

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X A75850 CA Primary
Primary Care Clinic/Center 261QP2300X A75850 CA

Addresses

Primary practice location

974 W Foothill Blvd
Upland, CA 91786-3728

Mailing address

974 W Foothill Blvd
Upland, CA 91786-3728
Phone (909) 932-1122

National Provider Directory

National Provider Directory

Locations

1175 E Arrow Hwy
Ste H
Upland, CA 91786
Phone (909) 920-1946

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439424000000",
    "number": "1821271420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "974 W FOOTHILL BLVD",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863728",
            "telephone_number": "909-932-1122",
            "fax_number": "909-932-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "974 W FOOTHILL BLVD",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863728",
            "telephone_number": "909-932-1122",
            "fax_number": "909-932-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORRIS KOKHAB, M.D., A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-06",
        "last_updated": "2015-08-13",
        "status": "A",
        "authorized_official_last_name": "KOKHAB",
        "authorized_official_first_name": "MORRIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-932-1122",
        "authorized_official_name_prefix": "Prof.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "A75850",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A75850",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2015; 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.