Individual
JEFFREY DEAN KOHFELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
72780 COUNTRY CLUB DR STE C300, RANCHO MIRAGE, CA 92270-4150
(760) 341-5550
(833) 471-2093
Mailing address
840 E MCKELLIPS RD STE 105, MESA, AZ 85203-9654
(602) 491-0701
(480) 631-0581
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA16230
CA
363AS0400X
Surgical Physician Assistant
PA16230
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MK0794758
—
CA
01
—
PA16230
CA LICENSE #
CA
Enumeration date
09/25/2006
Last updated
07/05/2023
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