MEDICARE: DR. DAVID A KAPLAN O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	527	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AZ0902310	OTHER	AZ	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1518079763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID A KAPLAN O.D.

Provider Business Mailing Address
First Line	:	19420 N 59TH AVE
Second Line	:	STE E525
City	:	GLENDALE
State	:	AZ
Zip	:	85308-6883
Country	:	US
Telephone Number	:	602-843-2900
Fax Number	:	602-843-0233

Provider Business Practice Location Address
First Line	:	19420 N 59TH AVE
Second Line	:	STE 130
City	:	GLENDALE
State	:	AZ
Zip	:	85308-6894
Country	:	US
Telephone Number	:	602-843-2900
Fax Number	:	602-843-0233

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	05/18/2017

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