Provider Demographics
NPI:1699912451
Name:KAHN, MARSHALL A (MD)
Entity type:Individual
Prefix:
First Name:MARSHALL
Middle Name:A
Last Name:KAHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9040 TELEGRAPH RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-2393
Mailing Address - Country:US
Mailing Address - Phone:562-927-0033
Mailing Address - Fax:562-231-1905
Practice Address - Street 1:9040 TELEGRAPH RD
Practice Address - Street 2:SUITE 102
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-2393
Practice Address - Country:US
Practice Address - Phone:562-927-0033
Practice Address - Fax:562-231-1905
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-15
Last Update Date:2015-03-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA28041207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A280410Medicaid
CABK746ZMedicare PIN
CA00A280410Medicaid