Provider Demographics
NPI:1194835058
Name:KATZMAN, LOUIS J (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:J
Last Name:KATZMAN
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 1:6071 VIA REGLA
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-3924
Mailing Address - Country:US
Mailing Address - Phone:858-457-1973
Mailing Address - Fax:619-615-2249
Practice Address - Street 1:6071 VIA REGLA
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-3924
Practice Address - Country:US
Practice Address - Phone:619-444-5917
Practice Address - Fax:619-444-1740
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG27392208600000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1790058501OtherNPI (CORPORATION)
CA00G273920Medicaid
CA1194835058OtherNPI (INDIVIDUAL)
CA1790058501OtherNPI (CORPORATION)
CA1194835058OtherNPI (INDIVIDUAL)