MEDICARE: MR. ROGER W KAUFMAN L.M.F.T.

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	106H00000X	Marriage & Family Therapist	MFC41434	CA

General Provider Information

NPI Number	:	1851536114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROGER W KAUFMAN L.M.F.T.

Provider Business Mailing Address
First Line	:	7080 HOLLYWOOD BLVD
Second Line	:	SUITE 801
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-6906
Country	:	US
Telephone Number	:	323-876-7051
Fax Number	:	323-876-7051

Provider Business Practice Location Address
First Line	:	7080 HOLLYWOOD BLVD
Second Line	:	SUITE 801
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-6906
Country	:	US
Telephone Number	:	323-876-7051
Fax Number	:	323-876-7051

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

Provider Enumeration Date	:	12/15/2008
Last Update Date	:	12/15/2008

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