Provider Demographics
NPI:1992289300
Name:SD HEALTHCARE SOLUTIONS
Entity type:Organization
Organization Name:SD HEALTHCARE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:I
Authorized Official - Last Name:KAUFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-738-4553
Mailing Address - Street 1:5943 THORN ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92105-3916
Mailing Address - Country:US
Mailing Address - Phone:619-933-9728
Mailing Address - Fax:
Practice Address - Street 1:5943 THORN ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-3916
Practice Address - Country:US
Practice Address - Phone:619-933-9728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-21
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G801070Medicaid
CA00A695150Medicaid