Provider Demographics
NPI:1023485422
Name:STEVEN F KAPLAN DPM A PROFESSIONAL PODIATRIC CORPORATION INC.
Entity type:Organization
Organization Name:STEVEN F KAPLAN DPM A PROFESSIONAL PODIATRIC CORPORATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:F
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:714-612-2581
Mailing Address - Street 1:404 W BASELINE RD
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-4801
Mailing Address - Country:US
Mailing Address - Phone:626-963-0302
Mailing Address - Fax:626-963-4703
Practice Address - Street 1:404 W BASELINE RD
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-4801
Practice Address - Country:US
Practice Address - Phone:626-963-0302
Practice Address - Fax:626-963-4703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-01
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2951261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E29510Medicaid
CAT19256Medicare UPIN