Healthcare Provider Details

I. General information

NPI: 1881743383
Provider Name (Legal Business Name): JEFFREY HOWARD KLEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16830 VENTURA BLVD SUITE 315
ENCINO CA
91436-1707
US

IV. Provider business mailing address

16830 VENTURA BLVD SUITE 315
ENCINO CA
91436-1707
US

V. Phone/Fax

Practice location:
  • Phone: 800-757-4242
  • Fax: 818-971-3580
Mailing address:
  • Phone: 800-757-4242
  • Fax: 818-971-3580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberG24094
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: