Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 266805 | MA |
N | 208600000X | Surgeon | 266805 | MA |
Y | 208800000X | Urologist | A171086 | CA |
NPI | 1053762948 |
---|---|
Provider Name | David Kuppermann |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095-8344 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2016 |
Last Update Date | 27/07/2021 |