Healthcare Provider Details

I. General information

NPI: 1891445482
Provider Name (Legal Business Name): ERIC P KUEHNE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14550 SOLEDAD CANYON RD
CANYON COUNTRY CA
91387-2200
US

IV. Provider business mailing address

PO BOX 9606
MISSION HILLS CA
91346-9602
US

V. Phone/Fax

Practice location:
  • Phone: 661-250-5200
  • Fax: 661-250-5210
Mailing address:
  • Phone: 213-394-7921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberA190247
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: