Provider Demographics
NPI:1912372517
Name:KAPLAN, RICHARD (RN)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2235 VUELTA GRANDE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815
Mailing Address - Country:US
Mailing Address - Phone:562-706-8335
Mailing Address - Fax:
Practice Address - Street 1:2235 VUELTA GRANDE AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-2354
Practice Address - Country:US
Practice Address - Phone:562-706-8335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-08
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAH306367261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center