Healthcare Provider Details

I. General information

NPI: 1902815954
Provider Name (Legal Business Name): BRIAN J KUHN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 FALLS CANYON ROAD
AVALON CA
90704-1563
US

IV. Provider business mailing address

209 RIFLE PEAK CT
INCLINE VILLAGE NV
89451-9619
US

V. Phone/Fax

Practice location:
  • Phone: 310-510-0700
  • Fax: 310-510-2381
Mailing address:
  • Phone: 775-831-9072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC38871
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: