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

Gary Khammahavong, MD

Individual provider Emergency Medicine Physician · NPI 1760989636

Gary Khammahavong, MD is an Emergency Medicine in Van Nuys, California. Graduated from Warren Alpert Medical School of Brown University in 2018, 8 years ago. Practices with Emergency Physicians Associates San Jose PC, a 133-clinician group and accepts Medicare assignment. Licensed in California and Pennsylvania.

Years since qualifying
8
Trained at
Warren Alpert Medical School of Brown University
Licensed in
CA, PA
In the registry since
2018
Specialties on file
3
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

15107 Vanowen St
Van Nuys, CA 91405-4542
Phone: (818) 782-6600
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence A175022 (CA)
Emergency Medicine Physician Taxonomy 207P00000X · Licence MD474559 (PA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1760989636
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 9, 2018
Last updated in NPPESMarch 2, 2022
Certification dateMarch 2, 2022
Mailing address185 39th St Apt D104, Pittsburgh, PA 15201-3235

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolWARREN ALPERT MEDICAL SCHOOL OF BROWN UNIVERSITY
Graduated 2018 (8 years in practice)
Group practice Emergency Physicians Associates San Jose Pc — 133 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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