Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | DC02654 | CA |
NPI | 1427179019 |
---|---|
Provider Name | Dr. Todd Kaufmann |
First Address | Corte Madera, CA 94925-1130 |
Second Address | Corte Madera, CA 94925-1130 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 08/07/2007 |