Individual provider Active NPI

Muhammad Khan KK, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1902493364
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
299545 Issued in CA
Practice address
3760 Convoy St Ste 100
San Diego, CA 92111-3743
Phone
(858) 573-9368
Fax
(858) 874-0582
NPI assigned
Dec 30, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 299545 CA Primary

Addresses

Primary practice location

3760 Convoy St Ste 100
San Diego, CA 92111-3743

Mailing address

3760 Convoy St Ste 101
San Diego, CA 92111-3743
Phone (858) 264-1434

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210113001363 CA Practitioner - Physical Therapist in Private Practice 6901219823 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
299545CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Care Physical Therapy Physical Therapist CurrentSince Dec 15, 2020 Accepting new patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince Dec 15, 2020 Accepting new patients
Complete P T Pool and Land Physical Therapy Inc CurrentSince May 17, 2021 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Mar 23, 2022 Accepting new patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince Dec 15, 2020 Accepting new patients

Locations

450 Rosewood Ave
Ste 105
Camarillo, CA 93010
Phone (805) 389-4781

1020 Tierra del Rey
Ste A1
Chula Vista, CA 91910
Phone (619) 585-7104

14150 Culver Dr
Ste 103
Irvine, CA 92604
Phone (949) 262-9142

3283 Motor Ave
Los Angeles, CA 90034
Phone (310) 559-6900

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

9852 Business Park Dr
Ste A
Sacramento, CA 95827
Phone (916) 362-7962

3760 Convoy St
Ste 100
San Diego, CA 92111
Phone (858) 264-1434

3760 Convoy St
Ste 101
San Diego, CA 92111
Phone (858) 264-1434

1801 Cleveland Ave
Ste B
Santa Rosa, CA 95401
Phone (707) 526-4180

Organizations & group practices 5

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": "1609286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1902493364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3760 CONVOY ST STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113743",
            "telephone_number": "858-264-1434",
            "fax_number": "858-751-0901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3760 CONVOY ST STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113743",
            "telephone_number": "858-573-9368",
            "fax_number": "858-874-0582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN KK",
        "first_name": "MUHAMMAD",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-30",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "299545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.