Healthcare Provider Details

I. General information

NPI: 1477545853
Provider Name (Legal Business Name): DAVID A KLEINER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DAVID KLEINER MD

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 03/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2030 W WHISPERING WIND DR
PHOENIX AZ
85085-2853
US

IV. Provider business mailing address

15650 N BLACK CANYON HWY SUITE 100
PHOENIX AZ
85053-4064
US

V. Phone/Fax

Practice location:
  • Phone: 602-866-0550
  • Fax: 602-993-5788
Mailing address:
  • Phone: 602-866-0550
  • Fax: 602-993-5788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25382
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: