Provider Demographics
NPI:1679942817
Name:STANLEY E. KAHAN MD, PC
Entity Type:Organization
Organization Name:STANLEY E. KAHAN MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:KAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-442-8238
Mailing Address - Street 1:462 DANIELS DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-4218
Mailing Address - Country:US
Mailing Address - Phone:310-442-8238
Mailing Address - Fax:310-442-4890
Practice Address - Street 1:8631 W 3RD ST
Practice Address - Street 2:SUITE 735E
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5901
Practice Address - Country:US
Practice Address - Phone:310-442-8238
Practice Address - Fax:310-442-4890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG42792207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE50607Medicare UPIN