Healthcare Provider Details

I. General information

NPI: 1154630267
Provider Name (Legal Business Name): KLAUSNER CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2010
Last Update Date: 11/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 JEWELL ST
SANTA CRUZ CA
95060-1717
US

IV. Provider business mailing address

129 JEWELL ST
SANTA CRUZ CA
95060-1717
US

V. Phone/Fax

Practice location:
  • Phone: 831-420-1400
  • Fax: 831-420-1401
Mailing address:
  • Phone: 831-420-1400
  • Fax: 831-420-1401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WARREN KLAUSNER
Title or Position: PRESIDENT
Credential: D.O.
Phone: 831-420-1400