Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | R3076 | AZ |
Y | 207Q00000X | Family Doctor | 007693 | AZ |
NPI | 1386023760 |
---|---|
Provider Name | Dr. Dana Michael Klein |
First Address | San Francisco, CA 94104-4009 |
Second Address | Gilbert, AZ 85295-0755 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2015 |
Last Update Date | 21/05/2019 |