Organization Active NPI

Imanuel Khalili M.D.., Inc

  • Primary Care Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1851805717
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
A128772 Issued in CA
Legal business name
IMANUEL KHALILI M.D.., INC
Practice address
1046 S Robertson Blvd
Los Angeles, CA 90035-1505
Phone
(424) 355-0301
Fax
(216) 208-1348
NPI assigned
Nov 29, 2017
Last updated
Jun 3, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Authorized official

Name
Dr. Imanuel Khalili, MDNPI 1447546627
Title
Ceo/ MD
Phone
(424) 355-0301

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X A128772 CA Primary

Addresses

Primary practice location

1046 S Robertson Blvd
Los Angeles, CA 90035-1505

Mailing address

1046 S Robertson Blvd
Los Angeles, CA 90035-1505
Phone (424) 355-0301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180123002456 CA Part B Supplier - Clinic/Group Practice 5991064800 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

1046 S Robertson Blvd
Los Angeles, CA 90035
Phone (424) 355-0301

1270 S Alfred St
Unit 352338
Los Angeles, CA 90035

Practitioners & affiliated clinicians

Practitioners 3

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": "1511913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780444800000",
    "number": "1851805717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1046 S ROBERTSON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351505",
            "telephone_number": "424-355-0301",
            "fax_number": "216-208-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 S ROBERTSON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351505",
            "telephone_number": "424-355-0301",
            "fax_number": "216-208-1348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMANUEL KHALILI M.D.., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-29",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A",
        "authorized_official_last_name": "KHALILI",
        "authorized_official_first_name": "IMANUEL",
        "authorized_official_title_or_position": "CEO/ MD",
        "authorized_official_telephone_number": "424-355-0301",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A128772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.