Healthcare Provider Details

I. General information

NPI: 1376726752
Provider Name (Legal Business Name): STEVE J KAHN DOM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2007
Last Update Date: 12/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 SENA ST
SANTA FE NM
87505-8835
US

IV. Provider business mailing address

324 SENA ST
SANTA FE NM
87505-8835
US

V. Phone/Fax

Practice location:
  • Phone: 505-988-3403
  • Fax:
Mailing address:
  • Phone: 505-988-3403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number824RX1
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: