Individual provider Active NPI

Clifford Robert Kahn, M.D.

  • Orthopaedic Surgery Physician
  • Encino, CA
National Provider Identifier
1619958626
Registry record updated Jun 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
G34659 Issued in CA
Practice address
17525 Ventura Blvd
Suite 203
Encino, CA 91316-5109
Phone
(818) 986-3366
Fax
(818) 986-3866
NPI assigned
Nov 7, 2005
Last updated
Jun 2, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 6268120001 CA
Orthopaedic Surgery Physician 207X00000X G34659 CA Primary
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X G34659 CA

Addresses

Primary practice location

17525 Ventura Blvd
Suite 203
Encino, CA 91316-5109

Mailing address

17525 Ventura Blvd
Suite 203
Encino, CA 91316-5109
Phone (818) 986-3366

Other identifiers 1

IdentifierTypeStateIssuer
00G346590MedicaidCA

Other names 1

  • Clifford Kahn Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081204000812 CA Practitioner - Orthopedic Surgery 2567406648 Practice locations: Tarzana, CA

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Baylor College of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5411 Etiwanda Ave
Suite 100
Tarzana, CA 91356-6159
Phone (818) 757-8839

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1163
Removal of skin lesions14
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G34659CAMDOrthopaedic Foot and Ankle Surgery Physician
6268120001CAMDDurable Medical Equipment & Medical Supplies

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Orthopedic and Spine Procedures LLC PastSince May 29, 2022 Accepting new patients
Clifford Kahn MD Foot and Ankle Surgery PastSince Jan 1, 1990 Accepting new patients
Payam Vahedifar MD Inc PastSince Mar 1, 2020 Accepting new patients
Tarzana Medical Center LLC Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275436800000",
    "number": "1619958626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17525 VENTURA BLVD",
            "address_2": "SUITE 203",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913165109",
            "telephone_number": "818-986-3366",
            "fax_number": "818-986-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17525 VENTURA BLVD",
            "address_2": "SUITE 203",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913165109",
            "telephone_number": "818-986-3366",
            "fax_number": "818-986-3866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAHN",
        "first_name": "CLIFFORD",
        "middle_name": "ROBERT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2010-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "6268120001",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G34659",
            "primary": true
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "CA",
            "license": "G34659",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G346590",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLIFFORD",
            "last_name": "KAHN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.