Healthcare Provider Details

I. General information

NPI: 1316153570
Provider Name (Legal Business Name): KLEIN MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 01/28/2020
Certification Date: 01/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CASS ST STE 116
MONTEREY CA
93940-2921
US

IV. Provider business mailing address

PO BOX 3224
MONTEREY CA
93942-3224
US

V. Phone/Fax

Practice location:
  • Phone: 831-758-4412
  • Fax:
Mailing address:
  • Phone: 831-758-4412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberG72711
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License NumberG71699
License Number StateCA

VIII. Authorized Official

Name: JUNE SELIBER-KLEIN
Title or Position: VP
Credential: MD
Phone: 831-758-4412