Provider Demographics
NPI:1528004470
Name:KAUFFMAN, JANE YANA (M,D)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:YANA
Last Name:KAUFFMAN
Suffix:
Gender:F
Credentials:M,D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8733 BEVERLY BLVD.
Mailing Address - Street 2:SUITE 312
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90048-1843
Mailing Address - Country:US
Mailing Address - Phone:310-652-6775
Mailing Address - Fax:310-652-6195
Practice Address - Street 1:8733 BEVERLY BLVD
Practice Address - Street 2:SUITE 312
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90048-1827
Practice Address - Country:US
Practice Address - Phone:310-652-6775
Practice Address - Fax:310-652-6195
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA51293207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A512931Medicaid
CAG16238Medicare UPIN