Provider Demographics
NPI:1699802520
Name:KLEIN, STEVEN T (OD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:T
Last Name:KLEIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16840 BERNARDO CENTER DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-5509
Mailing Address - Country:US
Mailing Address - Phone:858-487-5504
Mailing Address - Fax:858-487-3654
Practice Address - Street 1:16840 BERNARDO CENTER DR
Practice Address - Street 2:SUITE 150
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-5509
Practice Address - Country:US
Practice Address - Phone:858-487-5504
Practice Address - Fax:858-487-3654
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT9275T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWOP9275DMedicare ID - Type UnspecifiedMEDICARE (TIERRASANTA)
CAU20617Medicare UPIN
CAWOP9275CMedicare ID - Type UnspecifiedMEDICARE (TOTAL VISION)