Organization Active NPI

Ahura Healthcare Corporation

  • Interventional Pain Medicine Physician
  • Victorville, CA
National Provider Identifier
1861742991
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
AHURA HEALTHCARE CORPORATION
Practice address
14390 Civic Dr
Victorville, CA 92392-9709
Phone
(888) 873-6220
NPI assigned
Sep 17, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Authorized official

Name
Dr. Nikan KhatibiNPI 1326363300
Title
Medical Director
Phone
(888) 873-6220

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X Primary
Pain Clinic/Center 261QP3300X C3879752 CA

Addresses

Primary practice location

14390 Civic Dr
Victorville, CA 92392-9709

Mailing address

29911 Niguel Rd Unit 6429
Laguna Niguel, CA 92607-2417
Phone (949) 842-9628

Other practice location 1

1307 W 6th St
Suite 105
Corona, CA 92882-3294
Phone (888) 873-6220

Other practice location 2

160 N Date St
Escondido, CA 92025-3406
Phone (888) 873-6220

Other practice location 3

24910 Las Brisas Rd Ste 121
Murrieta, CA 92562-4035
Phone (888) 873-6220

Other names 1

  • Inland Pain Specialists Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170123000820 CA Part B Supplier - Clinic/Group Practice 6002198322 Receives reassigned benefits from 4 practitioners
Practice locations: Corona, CA; Victorville, CA; Murrieta, CA; Escondido, CA

National Provider Directory

National Provider Directory

Locations

1307 W 6th St
Ste 105
Corona, CA 92882
Phone (800) 674-7207

430 N Cedar St
Ste D
Escondido, CA 92025

160 N Date St
Escondido, CA 92025
Phone (760) 746-2860

15888 Main St
Ste 108
Hesperia, CA 92345
Phone (760) 244-4656

5153 Holt Blvd
Montclair, CA 91763
Phone (909) 625-6545

26940 E Hospital Rd
Moreno Valley, CA 92555
Phone 5132814400208

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609200000000",
    "number": "1861742991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29911 NIGUEL RD UNIT 6429",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926072417",
            "telephone_number": "949-842-9628",
            "fax_number": "888-873-6220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14390 CIVIC DR",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923929709",
            "telephone_number": "888-873-6220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1307 W 6th St",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "Corona",
            "state": "CA",
            "postal_code": "928823294",
            "country_code": "US",
            "telephone_number": "888-873-6220",
            "fax_number": "888-873-6220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "160 N Date St",
            "address_purpose": "LOCATION",
            "city": "Escondido",
            "state": "CA",
            "postal_code": "920253406",
            "country_code": "US",
            "telephone_number": "888-873-6220",
            "fax_number": "888-873-6220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24910 Las Brisas Rd Ste 121",
            "address_purpose": "LOCATION",
            "city": "Murrieta",
            "state": "CA",
            "postal_code": "925624035",
            "country_code": "US",
            "telephone_number": "888-873-6220",
            "fax_number": "888-876-6220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AHURA HEALTHCARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-17",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A",
        "authorized_official_last_name": "KHATIBI",
        "authorized_official_first_name": "NIKAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "888-873-6220",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "CA",
            "license": "C3879752",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Inland Pain Specialists",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Inland Pain Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; 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.