Healthcare Provider Details

I. General information

NPI: 1043444359
Provider Name (Legal Business Name): EUGENE KAPLAN, MD A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2009
Last Update Date: 12/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 LA CASA VIA SUITE 209
WALNUT CREEK CA
94598-3007
US

IV. Provider business mailing address

120 LA CASA VIA SUITE 209
WALNUT CREEK CA
94598-3007
US

V. Phone/Fax

Practice location:
  • Phone: 925-979-9969
  • Fax: 925-979-9979
Mailing address:
  • Phone: 925-979-9969
  • Fax: 925-979-9979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA672920
License Number StateCA

VIII. Authorized Official

Name: MRS. IRENA KAPLAN
Title or Position: PRACTICE MANAGER
Credential:
Phone: 925-979-9969