Provider Demographics
NPI:1366477028
Name:KAPLAN, JEFFREY (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:KAPLAN
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 1:821 E CHAPEL ST STE 203
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-4619
Mailing Address - Country:US
Mailing Address - Phone:805-354-5200
Mailing Address - Fax:805-354-5782
Practice Address - Street 1:821 E CHAPEL ST STE 203
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-4619
Practice Address - Country:US
Practice Address - Phone:805-354-5200
Practice Address - Fax:805-354-5782
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA74514208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1881941433Medicaid
CABN059ZOtherPTAN GROUP PLAN: W1508
CA1881941433Medicaid