Provider Demographics
NPI:1285819193
Name:STUART H KAPLAN, MD PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:STUART H KAPLAN, MD PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:HARRIS
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-858-7880
Mailing Address - Street 1:435 N ROXBURY DR STE 210
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5004
Mailing Address - Country:US
Mailing Address - Phone:310-858-7880
Mailing Address - Fax:310-858-7887
Practice Address - Street 1:435 N ROXBURY DR STE 210
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5004
Practice Address - Country:US
Practice Address - Phone:310-858-7880
Practice Address - Fax:310-858-7887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG55704207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG55704Medicaid
CAA53020Medicare UPIN