Provider Demographics
NPI:1497765028
Name:KAPLAN, LAWRENCE
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 CAMINO ALTO
Mailing Address - Street 2:STE 100A
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-2900
Mailing Address - Country:US
Mailing Address - Phone:415-459-2358
Mailing Address - Fax:
Practice Address - Street 1:61 CAMINO ALTO STE 100
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-2900
Practice Address - Country:US
Practice Address - Phone:415-381-2020
Practice Address - Fax:415-381-0774
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6475152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0064750Medicare PIN
U24363Medicare UPIN