Provider Demographics
NPI:1043227143
Name:KLEINER, ILONA (MD)
Entity Type:Individual
Prefix:DR
First Name:ILONA
Middle Name:
Last Name:KLEINER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4330 FULTON AVE
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-3907
Mailing Address - Country:US
Mailing Address - Phone:818-784-1102
Mailing Address - Fax:818-784-1653
Practice Address - Street 1:4330 FULTON AVE
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-3907
Practice Address - Country:US
Practice Address - Phone:818-784-1102
Practice Address - Fax:818-784-1653
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA74426208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics