Basic Information
| Provider Information | |||||||||
| NPI: | 1386751170 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KAHN | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | O | ||||||||
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| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 7464 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941207464 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4152063103 | ||||||||
| FaxNumber: | 4152063872 | ||||||||
| Practice Location | |||||||||
| Address1: | 995 POTRERO AVE | ||||||||
| Address2: | BLDG 80 WARD 84 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941103518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4154764082 | ||||||||
| FaxNumber: | 4154766953 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2006 | ||||||||
| LastUpdateDate: | 09/15/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | G52303 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207RX0202X | G52303 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
ID Information
| ID | Type | State | Issuer | Description | 00G523030 | 05 | CA | MEDICAID |