Healthcare Provider Details

I. General information

NPI: 1598711384
Provider Name (Legal Business Name): ROBERT A KLEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 11/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 BOULDER AVE
HIGHLAND CA
92346-3348
US

IV. Provider business mailing address

PO BOX 10069
SAN BERNARDINO CA
92423-0069
US

V. Phone/Fax

Practice location:
  • Phone: 909-862-1191
  • Fax: 909-796-4158
Mailing address:
  • Phone: 909-335-4188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberC36699
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: