Provider Demographics
NPI:1164508073
Name:KAUFHOLD, ANNE DOROTHY (MD)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:DOROTHY
Last Name:KAUFHOLD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2082 PARROT ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92105
Mailing Address - Country:US
Mailing Address - Phone:619-246-5535
Mailing Address - Fax:
Practice Address - Street 1:3177 OCEAN VIEW BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92113
Practice Address - Country:US
Practice Address - Phone:619-231-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA88893207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA88893AMedicare ID - Type Unspecified
I50099Medicare UPIN