Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Moemen Ahmed Khattab, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1417698903

Dr. Moemen Ahmed Khattab, MD is an Internal Medicine in Thousand Oaks, California. Qualified in 2022, 4 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California and Michigan.

Years since qualifying
4
Licensed in
CA, MI
In the registry since
2022
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Thousand Oaks, CA

Additional practice locations (1)

  • 9961 Sierra Ave, Fontana, CA 92335-6720 — (833) 574-2273

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 197267 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X
Internal Medicine Physician Taxonomy 207R00000X · Licence 4301513683 (MI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (CA)

Record details

NPI number1417698903
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 6, 2022
Last updated in NPPESJune 24, 2026
Certification dateJune 24, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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