Provider Demographics
NPI:1700802105
Name:KAHMANN, RICHARD DALY (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:DALY
Last Name:KAHMANN
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 1:2324 BATH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-4330
Mailing Address - Country:US
Mailing Address - Phone:805-682-7801
Mailing Address - Fax:805-569-5861
Practice Address - Street 1:2324 BATH ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4330
Practice Address - Country:US
Practice Address - Phone:805-682-7801
Practice Address - Fax:805-569-5861
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG51723207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G517230Medicaid
CAWG51723HOtherINDIVIDUAL PTAN
CA00G51723Medicaid
CAW745Medicare PIN
CA00G51723Medicaid
E02709Medicare UPIN
CAWG51723HOtherINDIVIDUAL PTAN