Provider Demographics
NPI:1982972675
Name:KAHN, RYAN ALLAN (DPT)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:ALLAN
Last Name:KAHN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 VETERANS BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-1750
Mailing Address - Country:US
Mailing Address - Phone:650-701-0390
Mailing Address - Fax:650-701-0105
Practice Address - Street 1:805 VETERANS BLVD STE 101
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1750
Practice Address - Country:US
Practice Address - Phone:650-701-0390
Practice Address - Fax:650-701-0105
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-08
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA385272251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ06783ZMedicare PIN
CAFW875ZMedicare PIN