Provider Demographics
NPI:1306078050
Name:KAPLAN, ADAM GEOFFREY (MD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:GEOFFREY
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1701 4TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-3658
Mailing Address - Country:US
Mailing Address - Phone:707-525-4051
Mailing Address - Fax:707-525-1033
Practice Address - Street 1:1701 4TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-3658
Practice Address - Country:US
Practice Address - Phone:707-525-4051
Practice Address - Fax:707-525-1033
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-13
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2014-00467208800000X
CAA114706208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA206361Medicare PIN