Provider Demographics
NPI:1619224557
Name:JANE Y KAUFFMAN, MD, PC
Entity Type:Organization
Organization Name:JANE Y KAUFFMAN, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:YANA
Authorized Official - Last Name:KAUFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-652-6775
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:90048-1827
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA51293174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty