Provider Demographics
NPI:1225193121
Name:KAHAN, JULIA SARAH (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:SARAH
Last Name:KAHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 KNOWLES DR
Mailing Address - Street 2:207
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-1549
Mailing Address - Country:US
Mailing Address - Phone:408-374-1110
Mailing Address - Fax:408-374-1133
Practice Address - Street 1:555 KNOWLES DR
Practice Address - Street 2:207
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1549
Practice Address - Country:US
Practice Address - Phone:408-374-1110
Practice Address - Fax:408-374-1133
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG69134174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF83558Medicare UPIN
CA00G069134Medicare ID - Type Unspecified