Healthcare Provider Details

I. General information

NPI: 1861413296
Provider Name (Legal Business Name): LEE KAPLAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 12/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9850 GENESEE AVE SUITE 460
LA JOLLA CA
92037-1228
US

IV. Provider business mailing address

9850 GENESEE AVE SUITE 460
LA JOLLA CA
92037-1224
US

V. Phone/Fax

Practice location:
  • Phone: 858-362-8800
  • Fax: 858-362-8803
Mailing address:
  • Phone: 858-362-8800
  • Fax: 858-362-8803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberG37152
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: