Provider Demographics
NPI:1215281787
Name:NEIL E KLEIN MD A MEDICAL CORPORATION
Entity type:Organization
Organization Name:NEIL E KLEIN MD A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:E
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-861-8246
Mailing Address - Street 1:11480 BROOKSHIRE AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-5024
Mailing Address - Country:US
Mailing Address - Phone:562-861-8246
Mailing Address - Fax:562-861-4869
Practice Address - Street 1:11480 BROOKSHIRE AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-5024
Practice Address - Country:US
Practice Address - Phone:562-861-8246
Practice Address - Fax:562-861-4869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA49074Medicare UPIN