Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | A50609 | CA |
NPI | 1013096080 |
---|---|
Provider Name | Alan M Kleinman |
First Address | Merced, CA 95344-3768 |
Second Address | Merced, CA 95348-3181 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 22/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F29716 | (02) | CA |