Provider Demographics
NPI:1639118185
Name:KAPLAN, DAVID J (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 N SAN MATEO DR
Mailing Address - Street 2:SUITE # 4
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-2885
Mailing Address - Country:US
Mailing Address - Phone:650-343-7775
Mailing Address - Fax:650-343-3954
Practice Address - Street 1:39 N SAN MATEO DR
Practice Address - Street 2:SUITE # 4
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-2885
Practice Address - Country:US
Practice Address - Phone:650-343-7775
Practice Address - Fax:650-343-3954
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE25750213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5280028OtherMEDI-CAL PROVIDER #
CA943071084OtherTAX PAYER ID
CAGRE000870Medicaid
CAE25750OtherSTATE LICENSE #
CA902342OtherQME #
CA902342OtherQME #
CAZZZ20238ZMedicare ID - Type UnspecifiedMEDICARE PROVIDER #
CAAK7096147OtherDEA #
CAGRE000870Medicaid
CA480020680Medicare PIN
CAE25750OtherSTATE LICENSE #