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General NPI Number Information
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NPI Number | 1558325456
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Entity Type | Individual
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Provider Name | JERRY ROBERT KLEIN MD
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Gender | Male
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 09/12/2007
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Provider Practice Location Address
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Address Line | 751 S BASCOM AVE JUVENILE HALL-PEDIATRICS
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City | SAN JOSE
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State | CA
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Zip | 95128-2604
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Country | US
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Telephone | 408-299-4841
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Fax |
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Provider Business Mailing Address
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Address Line | 751 S BASCOM AVE
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City | SAN JOSE
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State | CA
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Zip | 95128-2604
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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 |
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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 | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | G34236
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number | G34236
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License Number State | CA
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