Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | G67543 | CA |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | G67543 | CA |
NPI | 1083725659 |
---|---|
Provider Name | Jeffrey S. Kliman |
First Address | Los Altos, CA 94024 |
Second Address | Los Altos, CA 94024 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 14/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F12229 | (02) |