MEDICARE: DR. RICHARD LUDWIG KLEINBERGER PHARM.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	45059	CA

General Provider Information

NPI Number	:	1063716249
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD LUDWIG KLEINBERGER PHARM.D

Provider Business Mailing Address
First Line	:	17150 BURBANK BLVD UNIT 24
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91316-1839
Country	:	US
Telephone Number	:	424-653-9095
Fax Number	:

Provider Business Practice Location Address
First Line	:	17150 BURBANK BLVD UNIT 24
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91316-1839
Country	:	US
Telephone Number	:	424-653-9095
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2011
Last Update Date	:	01/03/2011

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