Provider Demographics
NPI:1063497741
Name:KLEEN, STEVEN ROY (OD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ROY
Last Name:KLEEN
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 1:2745 MOLIERE CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89044-0316
Mailing Address - Country:US
Mailing Address - Phone:909-792-3457
Mailing Address - Fax:909-307-1863
Practice Address - Street 1:2050 W REDLANDS BLVD
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-6228
Practice Address - Country:US
Practice Address - Phone:909-792-3457
Practice Address - Fax:909-307-1863
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT6721TPL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty