Healthcare Provider Details

I. General information

NPI: 1932272317
Provider Name (Legal Business Name): PAUL ELIAS KAPLAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 05/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5650 MARCONI AVE STE 6
CARMICHAEL CA
95608
US

IV. Provider business mailing address

104 SUMMER SHADE CT
FOLSOM CA
95630-1565
US

V. Phone/Fax

Practice location:
  • Phone: 916-799-1801
  • Fax: 916-927-1245
Mailing address:
  • Phone: 916-799-1801
  • Fax: 916-988-9919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberG14089
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: