Provider Demographics
NPI:1679542898
Name:KAHEN, TANAZ (MD)
Entity Type:Individual
Prefix:DR
First Name:TANAZ
Middle Name:
Last Name:KAHEN
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 1:4954 HESPERIA AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-4207
Mailing Address - Country:US
Mailing Address - Phone:818-996-9349
Mailing Address - Fax:818-344-3547
Practice Address - Street 1:5525 ETIWANDA AVE
Practice Address - Street 2:209
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3647
Practice Address - Country:US
Practice Address - Phone:818-344-8822
Practice Address - Fax:818-344-3587
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA79336207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW19566Medicare UPIN