Provider Demographics
NPI:1477545416
Name:KAUFMAN, TRAVIS KENNETH (DC)
Entity Type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:KENNETH
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4550 BALFOUR RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-1582
Mailing Address - Country:US
Mailing Address - Phone:925-308-7575
Mailing Address - Fax:925-240-7878
Practice Address - Street 1:4550 BALFOUR RD
Practice Address - Street 2:SUITE D
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-1582
Practice Address - Country:US
Practice Address - Phone:925-308-7575
Practice Address - Fax:925-240-7878
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28897111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U94213Medicare UPIN