MORRIS KOKHAB, M.D., A MEDICAL CORPORATION (NPI# 1821271420) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821271420 |
| Entity Type | Organization |
| Organization Name | MORRIS KOKHAB, M.D., A MEDICAL CORPORATION |
| Practice Address |
974 W Foothill Blvd Upland CA 91786-3728 |
| Practice Telephone | 9099321122 |
| Practice Fax Number | 9099329292 |
| Mailing Telephone | 9099321122 |
| Mailing Fax Number | 9099329292 |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2015-08-13 |
| Authorized Official Name | PROF. MORRIS KOKHAB (PRESIDENT) |
| Authorized Official Telephone | 9099321122 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
A75850 | CA | Ambulatory Health Care Facilities |
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
A75850 | CA | Ambulatory Health Care Facilities |
| Street Address |
974 W FOOTHILL BLVD |
| City | UPLAND |
| State | CA |
| Zip Code | 91786-3728 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528045358 | Louis Maximilian Dibernardo | Family Medicine | 974 W Foothill Blvd, Upland, CA 91786 | 2005-12-22 |
| 1922339092 | Advanced Medical and Urgent Care Center | Clinic/Center | 974 W Foothill Blvd, Upland, CA 91786-3728 | 2010-01-28 |
| 1952635237 | Marjan Khaleghi | Nurse Practitioner | 974 W Foothill Blvd, Upland, CA 91786-3728 | 2009-09-20 |
| 1073687588 | Nehal A. Tawansy | Family Medicine | 974 W Foothill Blvd, Upland, CA 91786-3728 | 2006-11-17 |
| 1245248681 | Morris Kokhab | Internal Medicine | 974 W Foothill Blvd, Upland, CA 91786-3728 | 2006-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366093254 | California Clinics, Inc | Physical Medicine & Rehabilitation | 818 N Mountain Ave Ste 102, Upland, CA 91786 | 2019-09-23 |
| 1699231621 | Lynn Keitz | Nurse Practitioner | 360 East 7th Street, Suite D, Upland, CA 91786 | 2019-02-14 |
| 1003386608 | Devin A Lockett | Counselor | 916 N, Mountain Ave. Suite D-1, Upland, CA 91786 | 2018-11-27 |
| 1265900096 | Right Ride | Driver | 1023 West Arrow Hwy Apt A, Upland, CA 91786 | 2018-11-09 |
| 1689142069 | Mike Sedat Safi | Driver | 1023 W Arrow Hwy, Apt A, Upland, CA 91786 | 2018-11-05 |
| 1902373640 | Barsoum Dental | Dentist | 258 E. 9th Street, Upland, CA 91786 | 2018-10-31 |
| 1346736600 | Jennifer Lynn Henshaw | Counselor | Rosewood Counseling Center, 288 W 9th Street, Upland, CA 91786 | 2018-07-10 |
| 1972099521 | Sadeg Aldolaim | Nurse Practitioner | 2086 W Arrow Route, Apt 824, Upland, CA 91786 | 2018-07-06 |
| 1831607332 | Sandra Sun | Pharmacist | 1445 E. Foothill Blvd., Upland, CA 91786 | 2018-01-18 |
| 1841713625 | Dynamic Performance Physical Therapy Inc | Clinic/Center | 2377 W. Foothill Blvd, Ste 20, Upland, CA 91786 | 2017-07-24 |
| Find all providers in zip 91786 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922536424 | Ardha Mobile Md LLC | Clinic/Center | 270 E 7th St Ste 1a, Upland, CA 91786-6602 | 2017-05-27 |
| 1902341142 | Steven Chow Md Inc | Clinic/Center | 886 W Foothill Blvd, Suite C, Upland, CA 91786-3769 | 2016-12-26 |
| 1063720514 | Truemed Acupuncture | Clinic/Center | 377 N 2nd Ave, Upland, CA 91786-6006 | 2010-09-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.