Provider Demographics
NPI:1720013782
Name:KAUFMAN, DAVID LYONS (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:LYONS
Last Name:KAUFMAN
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 1:2500 HOSPITAL DR
Mailing Address - Street 2:BUILDING 2
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4106
Mailing Address - Country:US
Mailing Address - Phone:650-691-8633
Mailing Address - Fax:650-644-0259
Practice Address - Street 1:2500 HOSPITAL DR
Practice Address - Street 2:BUILDING 2
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4106
Practice Address - Country:US
Practice Address - Phone:650-691-8633
Practice Address - Fax:650-644-0259
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY135662207R00000X
CAG89230207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01018184Medicaid
NY01018184Medicaid
CO7561Medicare UPIN