Provider Demographics
NPI:1134263783
Name:ROSS S. KAPLAN, M D A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:ROSS S. KAPLAN, M D A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:STUART
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-484-2813
Mailing Address - Street 1:3615 LAS POSAS RD
Mailing Address - Street 2:SUITE F 100
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-1479
Mailing Address - Country:US
Mailing Address - Phone:805-484-2813
Mailing Address - Fax:805-484-2316
Practice Address - Street 1:3615 LAS POSAS RD
Practice Address - Street 2:SUITE F 100
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-1479
Practice Address - Country:US
Practice Address - Phone:805-484-2813
Practice Address - Fax:805-484-2316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55764174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A55764Medicare ID - Type Unspecified
CAG93546Medicare UPIN