Provider Demographics
| NPI: | 1386751170 |
|---|---|
| Name: | KAHN, JAMES O (MD) |
| Entity type: | Individual |
| Prefix: | |
| First Name: | JAMES |
| Middle Name: | O |
| Last Name: | KAHN |
| Suffix: | |
| Gender: | M |
| 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: | PO BOX 7464 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | SAN FRANCISCO |
| Mailing Address - State: | CA |
| Mailing Address - Zip Code: | 94120-7464 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 415-206-3103 |
| Mailing Address - Fax: | 415-206-3872 |
| Practice Address - Street 1: | 995 POTRERO AVE |
| Practice Address - Street 2: | BLDG 80 WARD 84 |
| Practice Address - City: | SAN FRANCISCO |
| Practice Address - State: | CA |
| Practice Address - Zip Code: | 94110-3518 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 415-476-4082 |
| Practice Address - Fax: | 415-476-6953 |
| Is Sole Proprietor?: | No |
| Enumeration Date: | 2006-08-25 |
| Last Update Date: | 2011-09-15 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| CA | G52303 | 207R00000X, 207RX0202X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| No | 207RX0202X | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| CA | 00G523030 | Medicaid | |
| F79190 | Medicare UPIN | ||
| CA | 00G523030 | Medicare ID - Type Unspecified |