=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124027370
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANIEL M KLEINER D.P.M.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/19/2005
-----------------------------------------------------
Last Update Date | 11/25/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10201 MISSION GORGE RD SUITE K
-----------------------------------------------------
City | SANTEE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92071-3027
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-449-9100
-----------------------------------------------------
Fax | 619-449-0722
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10201 MISSION GORGE RD SUITE K
-----------------------------------------------------
City | SANTEE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92071-3027
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-449-9100
-----------------------------------------------------
Fax | 619-449-0722
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0131X
-----------------------------------------------------
Taxonomy Name | Foot Surgery Podiatrist
-----------------------------------------------------
License Number | 213ES0131X
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------