Provider Demographics
NPI:1407936784
Name:ROBERT P KAHN-ROSE, INC.
Entity Type:Organization
Organization Name:ROBERT P KAHN-ROSE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:P
Authorized Official - Last Name:KAHN-ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD - PHD
Authorized Official - Phone:818-385-1219
Mailing Address - Street 1:16311 VENTURA BLVD
Mailing Address - Street 2:SUITE 1205
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-4362
Mailing Address - Country:US
Mailing Address - Phone:818-385-1219
Mailing Address - Fax:818-385-1600
Practice Address - Street 1:16311 VENTURA BLVD
Practice Address - Street 2:SUITE 1205
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-4362
Practice Address - Country:US
Practice Address - Phone:818-385-1219
Practice Address - Fax:818-385-1600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG59791174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEP298AMedicare PIN