Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | G065628 | CA |
N | 208600000X | Surgeon | G065628 | CA |
Y | 2086S0129X | Vascular Surgeon | G065628 | CA |
NPI | 1083796379 |
---|---|
Provider Name | Jeffrey Kaplan |
First Address | San Jose, CA 95124-4006 |
Second Address | San Jose, CA 95124-4006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 14/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9054734 | (05) | CA |
BK1961879 | DEA (01) | |
E75976 | (02) |