Provider Demographics
NPI: | 1386751170 |
---|---|
Name: | KAHN, JAMES O (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | JAMES |
Middle Name: | O |
Last Name: | KAHN |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | PO BOX 7464 |
Mailing Address - Street 2: | |
Mailing Address - City: | SAN FRANCISCO |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 94120-7464 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 415-206-3103 |
Mailing Address - Fax: | 415-206-3872 |
Practice Address - Street 1: | 995 POTRERO AVE |
Practice Address - Street 2: | BLDG 80 WARD 84 |
Practice Address - City: | SAN FRANCISCO |
Practice Address - State: | CA |
Practice Address - Zip Code: | 94110-3518 |
Practice Address - Country: | US |
Practice Address - Phone: | 415-476-4082 |
Practice Address - Fax: | 415-476-6953 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-08-25 |
Last Update Date: | 2011-09-15 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | G52303 | 207R00000X, 207RX0202X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | |
No | 207RX0202X | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
CA | 00G523030 | Medicaid | |
F79190 | Medicare UPIN | ||
CA | 00G523030 | Medicare ID - Type Unspecified |