1699933556 NPI number — PEDRAM KAHEN, DPM INC.

Table of content: BARBARA JANE STONE PT (NPI 1811097454)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699933556 NPI number — PEDRAM KAHEN, DPM INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PEDRAM KAHEN, DPM INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699933556
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/28/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5140 WHITE OAK AVE
Provider Second Line Business Mailing Address:
SUITE 108
Provider Business Mailing Address City Name:
ENCINO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91316-2466
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-636-9559
Provider Business Mailing Address Fax Number:
413-639-9559

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
450 STANYAN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94117
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-668-1000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/28/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KAHEN
Authorized Official First Name:
PEDRAM
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO / OWNER
Authorized Official Telephone Number:
818-636-9559

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  E4774 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)