Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | C29332 | CA |
NPI | 1265451165 |
---|---|
Provider Name | William Berner Klaustermeyer |
First Address | Los Angeles, CA 90095 |
Second Address | Los Angeles, CA 90095 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00C293320 | MEDICAL PPIN # (01) | CA |
A87333 | (02) | CA |