Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | G34659 | CA |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | G34659 | CA |
NPI | 1619958626 |
---|---|
Provider Name | Clifford Robert Kahn |
First Address | Encino, CA 91316-5109 |
Second Address | Encino, CA 91316-5109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2005 |
Last Update Date | 02/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G346590 | (05) | CA |
A91615 | (02) | CA |