Provider Demographics
NPI:1033236765
Name:KLEIN, CALVIN ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:CALVIN
Middle Name:ROBERT
Last Name:KLEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ROBERT
Other - Middle Name:CALVIN ALFRED
Other - Last Name:KLEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5767 W CENTURY BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5632
Mailing Address - Country:US
Mailing Address - Phone:310-829-5471
Mailing Address - Fax:310-829-6192
Practice Address - Street 1:2336 SANTA MONICA BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2095
Practice Address - Country:US
Practice Address - Phone:310-829-5471
Practice Address - Fax:310-829-6192
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG19180207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G19180BMedicaid
CAA90582Medicare UPIN
CACE298Medicare PIN