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General NPI Number Information
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NPI Number | 1336359389
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Entity Type | Organization
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Legal Business Name | MARILYN KAUFHOLD, M.D., A MEDICAL CORPORATION
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3020 CHILDRENS WAY MC5014
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City | SAN DIEGO
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State | CA
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Zip | 92123-4223
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Country | US
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Telephone | 858-576-1700
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Fax |
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Provider Business Mailing Address
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Address Line | 2223 WHITMAN ST
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City | SAN DIEGO
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State | CA
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Zip | 92103-1128
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Country | US
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Telephone | 619-295-4283
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARILYN KAUFHOLD
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Credential | M.D.
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Telephone | 619-295-4283
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC2000X
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Taxonomy Name | Children's Hospital
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License Number | C33767
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License Number State | CA
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