Provider Demographics
NPI:1942252911
Name:KAHL, NATASHA ANN (MD)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:ANN
Last Name:KAHL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 SONOMA AVE
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-4817
Mailing Address - Country:US
Mailing Address - Phone:707-526-5034
Mailing Address - Fax:707-545-3984
Practice Address - Street 1:1140 SONOMA AVE
Practice Address - Street 2:STE 2A
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-4817
Practice Address - Country:US
Practice Address - Phone:707-526-5034
Practice Address - Fax:707-545-3984
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA62156207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A621560OtherMEDICAL PTAN
CA00A621561OtherMEDICARE
H09451Medicare UPIN