MEDICARE: DR. DAVID C. KLONOFF M.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	207R00000X	Internal Medicine Physician	G35726	CA
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	G35726	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306882949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID C. KLONOFF M.D.

Provider Business Mailing Address
First Line	:	1720 EL CAMINO REAL
Second Line	:	SUITE #130
City	:	BURLINGAME
State	:	CA
Zip	:	94010-3224
Country	:	US
Telephone Number	:	650-697-4345
Fax Number	:	650-259-5840

Provider Business Practice Location Address
First Line	:	1720 EL CAMINO REAL
Second Line	:	SUITE #130
City	:	BURLINGAME
State	:	CA
Zip	:	94010-3224
Country	:	US
Telephone Number	:	650-697-4345
Fax Number	:	650-259-5840

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

Provider Enumeration Date	:	06/21/2006
Last Update Date	:	08/30/2012

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