Provider Demographics
NPI:1073533899
Name:KUPFER, DAVID MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MICHAEL
Last Name:KUPFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3434 MIDWAY DR
Mailing Address - Street 2:SUITE 2004
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-4923
Mailing Address - Country:US
Mailing Address - Phone:619-223-2271
Mailing Address - Fax:619-221-4456
Practice Address - Street 1:3434 MIDWAY DR
Practice Address - Street 2:SUITE 2004
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-4923
Practice Address - Country:US
Practice Address - Phone:619-223-2271
Practice Address - Fax:619-221-4456
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG576212082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE89588Medicare UPIN
CAW18609Medicare ID - Type UnspecifiedINDIVIDUAL INCORPORATED