Healthcare Provider Details

I. General information

NPI: 1881787745
Provider Name (Legal Business Name): KAREN M KLINE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2433 CENTRAL AVE SUITE A
ALAMEDA CA
94501-6562
US

IV. Provider business mailing address

2433 CENTRAL AVE SUITE A
ALAMEDA CA
94501-6562
US

V. Phone/Fax

Practice location:
  • Phone: 510-521-2300
  • Fax: 510-521-7947
Mailing address:
  • Phone: 510-521-2300
  • Fax: 510-521-7947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA13730
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: