Healthcare Provider Details

I. General information

NPI: 1194427401
Provider Name (Legal Business Name): PAYAM JOHN KAHEN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 N LA CIENEGA BLVD STE 200
BEVERLY HILLS CA
90211-2246
US

IV. Provider business mailing address

50 N LA CIENEGA BLVD STE 200
BEVERLY HILLS CA
90211-2246
US

V. Phone/Fax

Practice location:
  • Phone: 310-289-0901
  • Fax: 310-388-3038
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MILENA NALBANDYAN
Title or Position: BILLING MANAGER
Credential:
Phone: 818-636-4310