Provider Demographics
NPI:1306906151
Name:KAMINSKI, ARTHUR D (MD)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:D
Last Name:KAMINSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 PALOMA AVE
Mailing Address - Street 2:#36
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90291-8711
Mailing Address - Country:US
Mailing Address - Phone:415-341-4451
Mailing Address - Fax:
Practice Address - Street 1:1300 N VERMONT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6005
Practice Address - Country:US
Practice Address - Phone:323-913-4892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019042325207P00000X
CAA82482207P00000X
IN01056932A207P00000X
IL036142477207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A824820Medicaid
CA00A824820Medicaid