Provider Demographics
NPI:1740214378
Name:KAUFMAN, ANDREW J (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:J
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:267 W HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-4211
Mailing Address - Country:US
Mailing Address - Phone:805-497-1694
Mailing Address - Fax:805-373-7493
Practice Address - Street 1:267 W HILLCREST DR
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-4211
Practice Address - Country:US
Practice Address - Phone:805-497-1694
Practice Address - Fax:805-373-7493
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG59570207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG59570DMedicare ID - Type UnspecifiedPPIN THOUSAND OAKS
CAS051669Medicare ID - Type UnspecifiedASC PROV NUMBER
CAE92121Medicare UPIN
CAG59570AMedicare ID - Type UnspecifiedPPIN SANTA BARBARA