Provider Demographics
NPI:1710121165
Name:KHAGI, SIMON (MD)
Entity Type:Individual
Prefix:DR
First Name:SIMON
Middle Name:
Last Name:KHAGI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:87 MCGREGOR STREET
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102
Mailing Address - Country:US
Mailing Address - Phone:603-695-2500
Mailing Address - Fax:
Practice Address - Street 1:1 HOAG DR BLDG 41
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-4162
Practice Address - Country:US
Practice Address - Phone:949-764-4060
Practice Address - Fax:949-764-4061
Is Sole Proprietor?:No
Enumeration Date:2009-04-29
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH15414207RH0003X
CA187017207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology