Healthcare Provider Details

I. General information

NPI: 1609194612
Provider Name (Legal Business Name): JOHN D KAUFMAN M D INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2010
Last Update Date: 09/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23861 MCBEAN PARKWAY SUITE E30
VALENCIA CA
91355-2077
US

IV. Provider business mailing address

23861 MCBEAN PARKWAY SUITE E30
VALENCIA CA
91355-2077
US

V. Phone/Fax

Practice location:
  • Phone: 661-259-3412
  • Fax: 661-259-7384
Mailing address:
  • Phone: 661-259-3412
  • Fax: 661-259-7384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberC35644
License Number StateCA

VIII. Authorized Official

Name: LISA GILMORE
Title or Position: OFFICE MANAGER
Credential:
Phone: 661-259-3412