Healthcare Provider Details

I. General information

NPI: 1912939604
Provider Name (Legal Business Name): HOWARD S KAUFMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 10/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 PICO ST
PASADENA CA
91105-3201
US

IV. Provider business mailing address

PO BOX 50487
PASADENA CA
91115-0487
US

V. Phone/Fax

Practice location:
  • Phone: 626-397-5896
  • Fax: 626-397-5899
Mailing address:
  • Phone: 626-397-5896
  • Fax: 626-397-5899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberC50932
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: