Babak Khorram, PHYSICIAN ASSISTANT

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA14508 Issued in CA

Practice address

13330 Bloomfield Ave
Norwalk, CA 90650-3251

Phone

(562) 868-0733

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Jacqueline B Aguiluz D O IncGroup PAC ID 8022040013, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Jacqueline B. Aguiluz, D.O. Inc

  • Family Medicine Physician
  • Hawaiian Gardens, CA
  • NPI 1851306724
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1902820152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 ROCKPORT",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926021050",
            "telephone_number": "562-868-0733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13330 BLOOMFIELD AVE",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906503251",
            "telephone_number": "562-868-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHORRAM",
        "first_name": "BABAK",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA14508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA14508",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth C Nieberg MD Inc
• Dylan Kenney
• Hedi Kermani, DDS, MDS
• Mandana Khalatbari, DDS
• Ali Asghar Raza Khan, DMD
• Hirad Khorramian
• Gohar Khosravi, M.D
• Kibrom G Asrat DPM Apc
• Kibrom G. Asrat DPM Apc Inc.
• Kiho Pai

• Medical Physician Assistant in Norwalk, CA
• Providers in Norwalk, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.