Provider Demographics
NPI:1366765844
Name:WILLIAM T KLOPE MD INC A MEDICAL CORPORATION
Entity type:Organization
Organization Name:WILLIAM T KLOPE MD INC A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:TAFT
Authorized Official - Last Name:KLOPE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-641-3689
Mailing Address - Street 1:2755 LOMA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-1544
Mailing Address - Country:US
Mailing Address - Phone:805-641-3689
Mailing Address - Fax:
Practice Address - Street 1:2755 LOMA VISTA RD
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-1544
Practice Address - Country:US
Practice Address - Phone:805-641-3689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-11
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG70045208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG70045Medicare PIN
CACY122AMedicare PIN