Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A40483 | CA |
N | 111NI0900X | Internist | A40483 | CA |
N | 207RG0100X | Gastroenterologist | A40483 | CA |
NPI | 1033205273 |
---|---|
Provider Name | Michael Eugene Klein |
First Address | Glendale, CA 91208 |
Second Address | Glendale, CA 91208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A85458 | (02) |