Healthcare Provider Details

I. General information

NPI: 1801455191
Provider Name (Legal Business Name): JASON ALAN KAPLAN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2019
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 HERNDON AVE STE 101
CLOVIS CA
93611-6304
US

IV. Provider business mailing address

6707 38TH AVE N
ST PETERSBURG FL
33710-1536
US

V. Phone/Fax

Practice location:
  • Phone: 599-890-3234
  • Fax:
Mailing address:
  • Phone: 278-009-9587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE5871
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: