Healthcare Provider Details

I. General information

NPI: 1437546355
Provider Name (Legal Business Name): GILBERT W KLIMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2015
Last Update Date: 04/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

573 SUMMERFIELD RD
SANTA ROSA CA
95405-5239
US

IV. Provider business mailing address

2105 DIVISADERO ST
SAN FRANCISCO CA
94115-2126
US

V. Phone/Fax

Practice location:
  • Phone: 707-531-7041
  • Fax:
Mailing address:
  • Phone: 415-292-7119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberG55912
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License NumberG55912
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License NumberG55912
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: