Provider Demographics
NPI:1609194612
Name:JOHN D KAUFMAN M D INC
Entity Type:Organization
Organization Name:JOHN D KAUFMAN M D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:GILMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-259-3412
Mailing Address - Street 1:23861 MCBEAN PARKWAY
Mailing Address - Street 2:SUITE E30
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-2077
Mailing Address - Country:US
Mailing Address - Phone:661-259-3412
Mailing Address - Fax:661-259-7384
Practice Address - Street 1:23861 MCBEAN PARKWAY
Practice Address - Street 2:SUITE E30
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-2077
Practice Address - Country:US
Practice Address - Phone:661-259-3412
Practice Address - Fax:661-259-7384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-14
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC35644207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C35644Medicare PIN