Provider Demographics
NPI:1255500724
Name:KAUFMAN, BRITNEY ELISE (PA)
Entity Type:Individual
Prefix:
First Name:BRITNEY
Middle Name:ELISE
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 CONCOURS ST.
Mailing Address - Street 2:BLDG 1, SUITE 1201
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764
Mailing Address - Country:US
Mailing Address - Phone:909-476-4077
Mailing Address - Fax:909-476-4088
Practice Address - Street 1:3333 CONCOURS ST
Practice Address - Street 2:BLDG 1, SUITE 1201
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764
Practice Address - Country:US
Practice Address - Phone:909-476-4077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21951363A00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207N00000XAllopathic & Osteopathic PhysiciansDermatology