Individual provider Active NPI

Henry Htwelay Khin, M.D.

  • Psychiatry Physician
  • Upland, CA
National Provider Identifier
1871639682
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A64156 Issued in CA
Practice address
732 N Mountain Ave Ste a
Upland, CA 91786-4372
Phone
(909) 579-2555
Fax
(909) 579-2118
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A064156 CA
Psychiatry Physician 2084P0800X A64156 CA Primary

Addresses

Primary practice location

732 N Mountain Ave Ste a
Upland, CA 91786-4372

Mailing address

2331 El Capitan Ave
Arcadia, CA 91006
Phone (626) 574-7102

Other practice location 1

540 W Baseline Rd Ste 3
Claremont, CA 91711-1612
Phone (909) 625-7175

Other practice location 2

2331 El Capitan Ave
Arcadia, CA 91006-5112
Phone (909) 579-2555

Other identifiers 1

IdentifierTypeStateIssuer
00A641560MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031106000689 CA Practitioner - Psychiatry 6002729076 Reassigns benefits to 1 organization
Practice locations: Arcadia, CA

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inland Psychiatric Medical Group IncGroup PAC ID 9436062312, 119 clinicians

Practice addresses (Care Compare)

540 W Baseline Rd
Suite 3
Claremont, CA 91711-1612
Phone (909) 625-7175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A064156CAMDPsychiatry Physician
A64156CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inland Psychiatric Medical Group, Inc Psychiatry CurrentSince Jul 1, 2014 Accepting new patients
Henry H Khin MD, Corporation Psychiatry Current Accepting new patients
Inland Psychiatric Medical Group Inc Psychiatry CurrentSince Jul 31, 2023 Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

540 W Baseline Rd
Ste 3
Claremont, CA 91711
Phone (909) 542-0633

16279 Walnut St
Ste A
Hesperia, CA 92345

16279 Walnut St
Hesperia, CA 92345
Phone (760) 243-7700

8710 Monroe Ct
Ste 150
Rancho Cucamonga, CA 91730
Phone (909) 941-4870

1809 W Redlands Blvd
Redlands, CA 92373
Phone (909) 307-1320

732 N Mountain Ave
Ste Ab
Upland, CA 91786
Phone (626) 975-1596

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1871639682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2331 EL CAPITAN AVE",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "91006",
            "telephone_number": "626-574-7102",
            "fax_number": "626-574-3970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 N MOUNTAIN AVE STE A",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864372",
            "telephone_number": "909-579-2555",
            "fax_number": "909-579-2118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "540 W Baseline Rd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Claremont",
            "state": "CA",
            "postal_code": "917111612",
            "country_code": "US",
            "telephone_number": "909-625-7175",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2331 El Capitan Ave",
            "address_purpose": "LOCATION",
            "city": "Arcadia",
            "state": "CA",
            "postal_code": "910065112",
            "country_code": "US",
            "telephone_number": "909-579-2555",
            "fax_number": "909-579-2118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHIN",
        "first_name": "HENRY",
        "middle_name": "HTWELAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A064156",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A64156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A641560",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.