Healthcare Provider Details

I. General information

NPI: 1639164676
Provider Name (Legal Business Name): MIKE S KLEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 E ROMIE LN STE B
SALINAS CA
93901-4000
US

IV. Provider business mailing address

PO BOX 241
SALINAS CA
93902-0241
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 TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberG72711
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: