Provider Demographics
NPI:1144495201
Name:KAHEN, PEDRAM (DPM)
Entity type:Individual
Prefix:DR
First Name:PEDRAM
Middle Name:
Last Name:KAHEN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 E MANCHESTER BLVD
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-1907
Mailing Address - Country:US
Mailing Address - Phone:888-535-3668
Mailing Address - Fax:888-269-5439
Practice Address - Street 1:511 E MANCHESTER BLVD
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-1907
Practice Address - Country:US
Practice Address - Phone:888-535-3668
Practice Address - Fax:888-269-5439
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE 4774213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery