Provider Demographics
NPI:1881613313
Name:KAMINSKY, LAWRENCE SCOTT (MD)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:SCOTT
Last Name:KAMINSKY
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 1:3905 SACRAMENTO ST
Mailing Address - Street 2:201
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1636
Mailing Address - Country:US
Mailing Address - Phone:415-923-3066
Mailing Address - Fax:415-929-9267
Practice Address - Street 1:3905 SACRAMENTO ST
Practice Address - Street 2:201
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1636
Practice Address - Country:US
Practice Address - Phone:415-923-3066
Practice Address - Fax:415-929-9267
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG39829207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G39829Medicaid
CAA47985Medicare UPIN
CA00G39829Medicaid