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General NPI Number Information
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NPI Number | 1659751121
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Entity Type | Individual
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Provider Name | RAYMOND EDWARD KLEINFELDER III D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/31/2015
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 3080 BRISTOL ST STE 650
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City | COSTA MESA
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State | CA
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Zip | 92626-7311
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Country | US
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Telephone | 949-317-2558
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Fax | 213-408-4414
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Provider Business Mailing Address
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Address Line | 11645 WILSHIRE BLVD STE 900
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City | LOS ANGELES
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State | CA
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Zip | 90025-6811
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Country | US
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Telephone | 424-243-7668
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Fax | 213-408-4414
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 036151703
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License Number State | IL
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