Provider Demographics
NPI:1922756378
Name:EUGENE THOMAS KAHN M D P C
Entity Type:Organization
Organization Name:EUGENE THOMAS KAHN M D P C
Other - Org Name:EUGENE THOMAS KAHN MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:KAHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:657-224-9209
Mailing Address - Street 1:10650 REAGAN ST
Mailing Address - Street 2:#97
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-8805
Mailing Address - Country:US
Mailing Address - Phone:657-224-9129
Mailing Address - Fax:657-224-9304
Practice Address - Street 1:3801 KATELLA AVE STE 320
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3344
Practice Address - Country:US
Practice Address - Phone:657-224-9209
Practice Address - Fax:657-224-9304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-15
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty