Individual ProviderSamuel W KaufmanPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansPractice Address825 Trinity Ln, Claremont, CA 91711-2957(909) 946-2801(909) 920-1049PECOS EnrollmentBased on the most recent information from CMS, provider Samuel W Kaufman does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 26 days ago.Profile DetailsProvider ID1790811610Provider TypeIndividualFull NameKaufman, Samuel WCredentialMDGenderMaleSole ProprietorYesEnumeration Date2/26/2007Last Updated4/20/2021Contact InformationPractice LocationPractice Address825 Trinity Ln, Claremont, CA 91711-2957Phone(909) 946-2801Fax(909) 946-3247Mailing LocationMailing AddressPO Box 996, Upland, CA 91785-0996Phone(909) 920-1049Fax(909) 946-3247Provider TaxonomiesCodeDescriptionLicenseCode2084P0800XPrimaryDescriptionPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansLicenseA28426CaliforniaProvider IdentifiersIDDescriptionIssuerID00A284260DescriptionMedicaidIssuerUnlistedCalifornia