MEDICARE: MS. PAMELA G KLEIN P.T.

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	225100000X	Physical Therapist	11371	CA

General Provider Information

NPI Number	:	1881861375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PAMELA G KLEIN P.T.

Provider Business Mailing Address
First Line	:	1006 GRAND TETON DR
Second Line	:
City	:	PACIFICA
State	:	CA
Zip	:	94044-3707
Country	:	US
Telephone Number	:	650-738-1999
Fax Number	:

Provider Business Practice Location Address
First Line	:	1006 GRAND TETON DR
Second Line	:
City	:	PACIFICA
State	:	CA
Zip	:	94044-3707
Country	:	US
Telephone Number	:	650-738-1999
Fax Number	:

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

Provider Enumeration Date	:	05/13/2008
Last Update Date	:	05/13/2008

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