Provider Demographics
NPI:1558433177
Name:KAUHANEN, KEITH G (MD)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:G
Last Name:KAUHANEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23388 MULHOLLAND DR
Mailing Address - Street 2:MAILSTOP 62
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2733
Mailing Address - Country:US
Mailing Address - Phone:818-876-1636
Mailing Address - Fax:818-295-3380
Practice Address - Street 1:4323 RIVERSIDE DRIVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4044
Practice Address - Country:US
Practice Address - Phone:818-295-3380
Practice Address - Fax:818-295-3380
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2012-01-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG35385207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine