Healthcare Provider Details

I. General information

NPI: 1639953532
Provider Name (Legal Business Name): PAUL G KLAS MD, FRCSC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2023
Last Update Date: 09/12/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 23RD ST BLDG 92ND
SAN FRANCISCO CA
94110-3504
US

IV. Provider business mailing address

100 DUBOCE AVE APT 402
SAN FRANCISCO CA
94103-1730
US

V. Phone/Fax

Practice location:
  • Phone: 628-206-8812
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA189816
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: