Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | G75922 | CA |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | G75922 | CA |
NPI | 1396704078 |
---|---|
Provider Name | Dr. Bruce S. Kahn |
First Address | Los Angeles, CA 90074-0001 |
Second Address | La Jolla, CA 92037-1027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2006 |
Last Update Date | 19/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G759220 | (05) | CA |
G69456 | (02) | CA |