MEDICARE: MICHAEL P KLEMENTICH RN

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	163W00000X	Registered Nurse	95222389	CA

General Provider Information

NPI Number	:	1124993233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL P KLEMENTICH RN

Provider Business Mailing Address
First Line	:	745 E VALLEY BLVD # 259
Second Line	:
City	:	SAN GABRIEL
State	:	CA
Zip	:	91776-3549
Country	:	US
Telephone Number	:	626-695-5737
Fax Number	:

Provider Business Practice Location Address
First Line	:	745 E VALLEY BLVD # 259
Second Line	:
City	:	SAN GABRIEL
State	:	CA
Zip	:	91776-3549
Country	:	US
Telephone Number	:	626-695-5737
Fax Number	:

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

Provider Enumeration Date	:	10/08/2025
Last Update Date	:	10/08/2025

Similar Medicare Providers

1750240008 — MARTINA TRUONG
Practice Location Address:

745 E VALLEY BLVD # 279
SAN GABRIEL, CA
91776-3549

Practice Phone: 626-328-0090
Practice Fax:

1356963896 — ALICE WANG LMFT
Practice Location Address:

745 E VALLEY BLVD # 325
SAN GABRIEL, CA
91776-3549

Practice Phone: 626-710-2915
Practice Fax:

1821076985 — CAROLYN R. HENDERSON MFT
Practice Location Address:

641 HIGUERA ST , SUITE 202
SAN LUIS OBISPO, CA
93401-3549

Practice Phone: 805-596-0234
Practice Fax: 805-929-2717

1861428104 — MR. KAYVAN BINAEI PA
Practice Location Address:

3549 CAMINO DEL RIO S , SUITE A
SAN DIEGO, CA
92108-4023

Practice Phone: 619-543-0144
Practice Fax: 619-543-0445

1669409876 — MICHAEL C MALLATT PAC
Practice Location Address:

220 MONTGOMERY ST STE 1212
SAN FRANCISCO, CA
94104-3549

Practice Phone: 415-392-8200
Practice Fax: 415-291-0489

1265534598 — TRESAMICI MANAGEMENT,INC
Practice Location Address:

1019 BOLIVAR PAGAN URB SAN MARTIN
SAN JUAN, PR
00918-3549

Practice Phone: 787-758-4242
Practice Fax:

Directions to “ MICHAEL P KLEMENTICH RN” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.