Healthcare Provider Details

I. General information

NPI: 1144265463
Provider Name (Legal Business Name): DANIEL ALBERT KAHN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 05/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2911 SISKIYOU BLVD
MEDFORD OR
97504-8179
US

IV. Provider business mailing address

2620 EAST BARNETT RD SUITE H
MEDFORD OR
97504-8383
US

V. Phone/Fax

Practice location:
  • Phone: 541-789-5982
  • Fax: 541-789-5983
Mailing address:
  • Phone: 541-789-4281
  • Fax: 541-789-5538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberA87014
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberA87014
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberMD171685
License Number StateOR
# 4
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberMD171685
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: