Healthcare Provider Details

I. General information

NPI: 1124027370
Provider Name (Legal Business Name): DANIEL M KLEINER D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 11/25/2008
Certification Date:
Deactivation Date: 03/20/2006
Reactivation Date: 03/27/2006

III. Provider practice location address

10201 MISSION GORGE RD SUITE K
SANTEE CA
92071-3027
US

IV. Provider business mailing address

10201 MISSION GORGE RD SUITE K
SANTEE CA
92071-3027
US

V. Phone/Fax

Practice location:
  • Phone: 619-449-9100
  • Fax: 619-449-0722
Mailing address:
  • Phone: 619-449-9100
  • Fax: 619-449-0722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number213ES0131X
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: