Healthcare Provider Details

I. General information

NPI: 1356310502
Provider Name (Legal Business Name): ZEV M KAHN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 11/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19845 LAKE CHABOT RD SUITE 302
CASTRO VALLEY CA
94546-4055
US

IV. Provider business mailing address

PO BOX 255789
SACRAMENTO CA
95865-5789
US

V. Phone/Fax

Practice location:
  • Phone: 510-886-3400
  • Fax: 510-581-6517
Mailing address:
  • Phone: 916-854-6975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License NumberA25422
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: