Active NPI
Donald D. Kaiserman, M.D.
- Neurology Physician
- West Covina, CA
National Provider Identifier
1891739108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- C26455
- Practice address
- 1115 S Sunset Ave
West Covina, CA 91790-3940 - Phone
- (626) 813-9988
- Fax
- (626) 813-0075
- NPI assigned
- Jun 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | C26455 | CA | Primary |
| Diagnostic Radiology Physician | 2085R0202X | C26455 | CA |
Addresses
Primary practice location
1115 S Sunset Ave
West Covina, CA 91790-3940
Mailing address
PO Box 635
West Covina, CA 91793-0635
Phone (626) 813-9988
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300034667 | Other | CA | MEDICARE RR |
| GR0058271 | Other | CA | MEDI-CAL GROUP NUMBER |
| GR0058270 | Other | CA | MEDI-CAL GROUP NUMBER |
| 00C264550 | Other | CA | BCBS |
| 00C264550 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C26455 | CA | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208822400000",
"number": "1891739108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 635",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917930635",
"telephone_number": "626-813-9988",
"fax_number": "626-813-0075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1115 S SUNSET AVE",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917903940",
"telephone_number": "626-813-9988",
"fax_number": "626-813-0075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAISERMAN",
"first_name": "DONALD",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-16",
"last_updated": "2008-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "CA",
"license": "C26455",
"primary": true
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "C26455",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR",
"identifier": "300034667",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL GROUP NUMBER",
"identifier": "GR0058271",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL GROUP NUMBER",
"identifier": "GR0058270",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "00C264550",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00C264550",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.