MEDICARE: DR. VERA KLEYNBERG 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	207RH0003X	Hematology & Oncology Physician	00A769390	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	:	1568428324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VERA KLEYNBERG M.D.

Provider Business Mailing Address
First Line	:	6221 WILSHIRE BLVD.
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-5724
Country	:	US
Telephone Number	:	323-965-9995
Fax Number	:

Provider Business Practice Location Address
First Line	:	6221 WILSHIRE BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-5201
Country	:	US
Telephone Number	:	323-965-9995
Fax Number	:

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

Provider Enumeration Date	:	04/21/2006
Last Update Date	:	07/08/2007

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