Provider Demographics
NPI: | 1104984442 |
---|---|
Name: | KLAPPER, ROBERT C (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | ROBERT |
Middle Name: | C |
Last Name: | KLAPPER |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 8737 BEVERLY BLVD STE 303 |
Mailing Address - Street 2: | |
Mailing Address - City: | WEST HOLLYWOOD |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 90048-1839 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 310-659-6889 |
Mailing Address - Fax: | 310-657-3841 |
Practice Address - Street 1: | 8737 BEVERLY BLVD STE 303 |
Practice Address - Street 2: | |
Practice Address - City: | WEST HOLLYWOOD |
Practice Address - State: | CA |
Practice Address - Zip Code: | 90048-1839 |
Practice Address - Country: | US |
Practice Address - Phone: | 310-659-6889 |
Practice Address - Fax: | 310-657-3841 |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2006-12-05 |
Last Update Date: | 2016-03-15 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | G53861 | 207X00000X, 207XX0005X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207XX0005X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine |
No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
CA | 00G538610 | Medicaid | |
ED2743 | Medicare UPIN | ||
CA | 00G538610 | Medicaid |