Provider Demographics
NPI:1093863722
Name:KAUFMAN, AVRUM AARON (DO)
Entity Type:Individual
Prefix:DR
First Name:AVRUM
Middle Name:AARON
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 CORPORATE DR
Mailing Address - Street 2:SUITE 290
Mailing Address - City:LADERA RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92694-1152
Mailing Address - Country:US
Mailing Address - Phone:949-218-5200
Mailing Address - Fax:
Practice Address - Street 1:800 CORPORATE DR
Practice Address - Street 2:SUITE 290
Practice Address - City:LADERA RANCH
Practice Address - State:CA
Practice Address - Zip Code:92694-1152
Practice Address - Country:US
Practice Address - Phone:949-218-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7892207YS0123X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A7892OtherSTATE LICENSE
CAW20A7892BMedicare ID - Type UnspecifiedPPIN