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General NPI Number Information
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NPI Number | 1134725732
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Entity Type | Organization
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Legal Business Name | THE KLEK GROUP, INC.
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Dates
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Enumeration Date | 12/08/2020
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Last Update Date | 12/08/2020
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Provider Practice Location Address
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Address Line | 1200 N STATE ST STE 3300
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City | LOS ANGELES
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State | CA
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Zip | 90089-1001
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Country | US
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Telephone | 415-662-0981
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Fax |
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Provider Business Mailing Address
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Address Line | 1107 FAIR OAKS AVE STE 809
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City | SOUTH PASADENA
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State | CA
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Zip | 91030-3311
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KENNETH LIU
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Credential | MD
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Telephone | 415-662-0981
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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