Healthcare Provider Details

I. General information

NPI: 1689659724
Provider Name (Legal Business Name): JOHN WARD KUHN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7551 MADISON AVE
CITRUS HEIGHTS CA
95610-7449
US

IV. Provider business mailing address

904 DEL MAR CT
ROSEVILLE CA
95661-5306
US

V. Phone/Fax

Practice location:
  • Phone: 916-904-3032
  • Fax:
Mailing address:
  • Phone: 916-904-3032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG30989
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: