Provider Demographics
NPI:1346340809
Name:KATSKE, FLOYD A (MD)
Entity Type:Individual
Prefix:
First Name:FLOYD
Middle Name:A
Last Name:KATSKE
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 1:23928 LYONS AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2409
Mailing Address - Country:US
Mailing Address - Phone:661-254-2777
Mailing Address - Fax:661-254-2777
Practice Address - Street 1:23928 LYONS AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2409
Practice Address - Country:US
Practice Address - Phone:661-254-2777
Practice Address - Fax:661-254-2777
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG 36408208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA91777Medicare UPIN
CAG36408AMedicare ID - Type Unspecified
CAG36408AMedicare PIN