Healthcare Provider Details

I. General information

NPI: 1265451777
Provider Name (Legal Business Name): DAVID JORDAN KLASHMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 11/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23441 MADISON ST SUITE #340
TORRANCE CA
90505-4725
US

IV. Provider business mailing address

23441 MADISON ST SUITE #340
TORRANCE CA
90505-4725
US

V. Phone/Fax

Practice location:
  • Phone: 310-373-0340
  • Fax: 310-373-7142
Mailing address:
  • Phone: 310-373-0340
  • Fax: 310-373-7142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberG56545
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: