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General NPI Number Information
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NPI Number | 1437197548
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Entity Type | Individual
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Provider Name | TIMOTHY LEE KLEIN-MOHR PTA
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Gender | Male
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 11/05/2013
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Provider Practice Location Address
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Address Line | 26522 LA ALAMEDA SUITE 100
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City | MISSION VIEJO
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State | CA
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Zip | 92691-6330
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Country | US
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Telephone | 949-582-2555
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Fax |
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Provider Business Mailing Address
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Address Line | 7 FLOWERIDGE CIR
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-4903
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Country | US
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Telephone | 949-481-9869
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | AT6197
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License Number State | CA
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