Provider Demographics
NPI:1700824828
Name:KAPLAN, JONATHAN L (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:L
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 WEBSTER ST
Mailing Address - Street 2:SUITE 429
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2373
Mailing Address - Country:US
Mailing Address - Phone:415-923-3005
Mailing Address - Fax:415-771-6561
Practice Address - Street 1:2100 WEBSTER ST
Practice Address - Street 2:SUITE 429
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2373
Practice Address - Country:US
Practice Address - Phone:415-923-3005
Practice Address - Fax:415-771-6561
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA024942207P00000X, 2086S0122X, 208200000X
CAC55493208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00688011Medicaid
CA4E680CP42OtherMEDICARE
LA1421219Medicaid
LA1421219Medicaid
CA4E680CY70Medicare PIN
CA4E680CP42OtherMEDICARE
LA4E680CP42Medicare ID - Type Unspecified
4E680CY70Medicare PIN