Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 213ES0131X | CA |
NPI | 1124027370 |
---|---|
Provider Name | Daniel M Kleiner |
First Address | Santee, CA 92071-3027 |
Second Address | Santee, CA 92071-3027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2005 |
Last Update Date | 25/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000E15740 | (05) | CA |
T11001 | (02) | CA |