Healthcare Provider Details

I. General information

NPI: 1831221126
Provider Name (Legal Business Name): DOROTHY CUYSON KLEIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DOROTHY CUYSON DICKMAN M.D.

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 01/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7935 WESTLAWN AVE
LOS ANGELES CA
90045-1071
US

IV. Provider business mailing address

7935 WESTLAWN AVE
LOS ANGELES CA
90045-1071
US

V. Phone/Fax

Practice location:
  • Phone: 310-431-9507
  • Fax: 310-431-9507
Mailing address:
  • Phone: 310-431-9507
  • Fax: 310-431-9507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA93473
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: