MEDICARE: SHIRA MICHELLE KAUFMAN RD

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	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1518892694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIRA MICHELLE KAUFMAN RD

Provider Business Mailing Address
First Line	:	2882 ANGELO DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90077-2104
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	555 S BARRINGTON AVE APT 209
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-4350
Country	:	US
Telephone Number	:	424-302-7312
Fax Number	:

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

Provider Enumeration Date	:	06/17/2026
Last Update Date	:	06/17/2026

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