Organization Active NPI

Michael E Kan MD

  • Family Medicine Physician
  • Los Gatos, CA
National Provider Identifier
1689975435
Registry record updated Nov 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G53368 Issued in CA
Legal business name
MICHAEL E KAN MD
Practice address
360 Dardanelli LN Ste 1G
Los Gatos, CA 95032-1421
Phone
(408) 378-2900
Fax
(408) 378-2039
NPI assigned
Nov 10, 2010
Last updated
Nov 10, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2010

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

Authorized official

Name
Dr. Michael Edmond KanNPI 1558414623
Title
President
Phone
(408) 378-2900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G53368 CA Primary

Addresses

Primary practice location

360 Dardanelli LN Ste 1G
Los Gatos, CA 95032-1421

Mailing address

360 Dardanelli LN Ste 1G
Los Gatos, CA 95032-1421
Phone (408) 378-2900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120203000377 CA Part B Supplier - Clinic/Group Practice 9739346602 Receives reassigned benefits from 1 practitioner
Practice locations: Los Gatos, CA

National Provider Directory

National Provider Directory
Tax ID family
Michael E Kan Family Practice2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

320 Dardanelli Ln
Ste 22
Los Gatos, CA 95032
Phone (408) 374-3950

360 Dardanelli Ln
Ste 1G
Los Gatos, CA 95032
Phone (408) 378-2900

1390 S Winchester Blvd
Ste F1
San Jose, CA 95128
Phone (408) 378-2900

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1289347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289347200000",
    "number": "1689975435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 DARDANELLI LN STE 1G",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321421",
            "telephone_number": "408-378-2900",
            "fax_number": "408-378-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 DARDANELLI LN STE 1G",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321421",
            "telephone_number": "408-378-2900",
            "fax_number": "408-378-2039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL E KAN MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-10",
        "last_updated": "2010-11-10",
        "status": "A",
        "authorized_official_last_name": "KAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "EDMOND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-378-2900",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G53368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.