Provider Demographics
NPI:1568475358
Name:KLINGSBERG, HOWARD (DC)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:
Last Name:KLINGSBERG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6134 WILSHIRE BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:AL
Mailing Address - Zip Code:90048-3950
Mailing Address - Country:US
Mailing Address - Phone:323-938-3996
Mailing Address - Fax:323-938-4959
Practice Address - Street 1:6134 WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5102
Practice Address - Country:US
Practice Address - Phone:323-938-3996
Practice Address - Fax:323-938-4959
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC11607111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATO4415Medicare UPIN