Healthcare Provider Details

I. General information

NPI: 1285819193
Provider Name (Legal Business Name): STUART H KAPLAN, MD PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2008
Last Update Date: 08/23/2023
Certification Date: 08/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 N ROXBURY DR STE 210
BEVERLY HILLS CA
90210-5004
US

IV. Provider business mailing address

435 N ROXBURY DR STE 210
BEVERLY HILLS CA
90210-5004
US

V. Phone/Fax

Practice location:
  • Phone: 310-858-7880
  • Fax: 310-858-7887
Mailing address:
  • Phone: 310-858-7880
  • Fax: 310-858-7887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberG55704
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberG55704
License Number StateCA

VIII. Authorized Official

Name: DR. STUART HARRIS KAPLAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 310-858-7880