Provider Demographics
NPI:1982822425
Name:KLEMAN, MELISSA A (OD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:A
Last Name:KLEMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 LAGUNA DRIVE
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-3730
Mailing Address - Country:US
Mailing Address - Phone:760-729-7101
Mailing Address - Fax:760-729-7106
Practice Address - Street 1:655 LAGUNA DR
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1610
Practice Address - Country:US
Practice Address - Phone:760-729-7101
Practice Address - Fax:760-729-7106
Is Sole Proprietor?:No
Enumeration Date:2007-04-22
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13387152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist