Organization Active NPI

Moyeen Khaleeli M.D. Inc

  • Hematology & Oncology Physician
  • Torrance, CA
National Provider Identifier
1902122617
Registry record updated Oct 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
A26266 Issued in CA
Legal business name
MOYEEN KHALEELI M.D. INC
Practice address
4305 Torrance Blvd
409
Torrance, CA 90503-4409
Phone
(310) 371-2110
Fax
(310) 371-6102
NPI assigned
Apr 20, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2014

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

Authorized official

Name
Moyeen Khaleeli, M.D.NPI 1255490660
Title
President
Phone
(310) 371-2110

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
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X A26266 CA
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X A26266 CA Primary

Addresses

Primary practice location

4305 Torrance Blvd
409
Torrance, CA 90503-4409

Mailing address

4305 Torrance Blvd
409
Torrance, CA 90503-4409
Phone (310) 371-2110

Other identifiers 1

IdentifierTypeStateIssuer
00A262660MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100616000894 CA Part B Supplier - Clinic/Group Practice 8527198621 Receives reassigned benefits from 1 practitioner
Practice locations: Torrance, CA

National Provider Directory

National Provider Directory

Locations

14165 Purche Ave
Gardena, CA 90249
Phone (310) 323-4570

3336 Lomita Blvd
Torrance, CA 90505

Practitioners & affiliated clinicians

Practitioners 1

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": "1271721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412640000000",
    "number": "1902122617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 TORRANCE BLVD",
            "address_2": "409",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034409",
            "telephone_number": "310-371-2110",
            "fax_number": "310-371-6102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 TORRANCE BLVD",
            "address_2": "409",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034409",
            "telephone_number": "310-371-2110",
            "fax_number": "310-371-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOYEEN KHALEELI M.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-20",
        "last_updated": "2014-10-07",
        "status": "A",
        "authorized_official_last_name": "KHALEELI",
        "authorized_official_first_name": "MOYEEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-371-2110",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A26266",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A26266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A262660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; 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.