Provider Demographics
NPI:1093718165
Name:KLEIN, MARK JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:JAY
Last Name:KLEIN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 4363
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93912-4363
Mailing Address - Country:US
Mailing Address - Phone:831-757-2058
Mailing Address - Fax:831-757-0232
Practice Address - Street 1:1033 LOS PALOS DR
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3916
Practice Address - Country:US
Practice Address - Phone:831-757-2058
Practice Address - Fax:831-757-0232
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2014-06-06
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Provider Licenses
StateLicense IDTaxonomies
CAG22851207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA41745Medicare UPIN