MEDICARE: DR. LOWELL J KLEINMAN

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	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician	A51155	CA
2	207Q00000X	Family Medicine Physician	00A511550	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00A511550	OTHER		STATE LICENSE

General Provider Information

NPI Number	:	1407875941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOWELL J KLEINMAN

Provider Business Mailing Address
First Line	:	8695 SPECTRUM CENTER BLVD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-1489
Country	:	US
Telephone Number	:	858-798-9083
Fax Number	:	760-705-1533

Provider Business Practice Location Address
First Line	:	7525 LINDA VISTA RD STE A
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-5344
Country	:	US
Telephone Number	:	858-277-2361
Fax Number	:	858-569-1981

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

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	01/02/2025

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