Healthcare Provider Details

I. General information

NPI: 1881865541
Provider Name (Legal Business Name): CYNTHIA DAWN KLEIN HAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2008
Last Update Date: 01/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3870 MISSION AVE D-5
OCEANSIDE CA
92058-1880
US

IV. Provider business mailing address

FILE #55745
LOS ANGELES CA
90074-5745
US

V. Phone/Fax

Practice location:
  • Phone: 760-721-1141
  • Fax: 760-721-0938
Mailing address:
  • Phone: 760-721-1141
  • Fax: 760-721-0938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHA7347
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: