Healthcare Provider Details

I. General information

NPI: 1861497968
Provider Name (Legal Business Name): SHELDON N. KLAUSNER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 01/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 SANTA MONICA BLVD STE 870-W
SANTA MONICA CA
90404-2102
US

IV. Provider business mailing address

2001 SANTA MONICA BLVD STE 870-W
SANTA MONICA CA
90404-2102
US

V. Phone/Fax

Practice location:
  • Phone: 310-829-1703
  • Fax: 310-494-9450
Mailing address:
  • Phone: 310-829-1703
  • Fax: 310-494-9450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberG10015
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: