Provider Demographics
NPI:1063716249
Name:KLEINBERGER, RICHARD LUDWIG (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LUDWIG
Last Name:KLEINBERGER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:RICHARD
Other - Middle Name:
Other - Last Name:KNUROWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:17150 BURBANK BLVD UNIT 24
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-1839
Mailing Address - Country:US
Mailing Address - Phone:424-653-9095
Mailing Address - Fax:
Practice Address - Street 1:17150 BURBANK BLVD UNIT 24
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-1839
Practice Address - Country:US
Practice Address - Phone:424-653-9095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-03
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA450591835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist