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General NPI Number Information
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NPI Number | 1063744530
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Entity Type | Organization
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Legal Business Name | SAMUEL W. KAUFMAN, M.D., INC.
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Dates
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Enumeration Date | 02/08/2010
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Last Update Date | 02/08/2010
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Provider Practice Location Address
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Address Line | 4515 ORCHARD ST
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City | MONTCLAIR
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State | CA
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Zip | 91763-3102
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Country | US
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Telephone | 909-946-2801
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Fax | 909-946-3247
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Provider Business Mailing Address
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Address Line | PO BOX 996
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City | UPLAND
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State | CA
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Zip | 91785-0996
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Country | US
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Telephone | 909-946-2801
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Fax | 909-946-3247
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Authorized Official
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Title or Position | BILLER
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Name | EILEEN VRIEZE
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Credential |
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Telephone | 909-946-2801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A28426
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License Number State | CA
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