Provider Demographics
| NPI: | 1104984442 |
|---|---|
| Name: | KLAPPER, ROBERT C (MD) |
| Entity type: | Individual |
| Prefix: | |
| First Name: | ROBERT |
| Middle Name: | C |
| Last Name: | KLAPPER |
| Suffix: | |
| Gender: | M |
| 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: | 8737 BEVERLY BLVD STE 303 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | WEST HOLLYWOOD |
| Mailing Address - State: | CA |
| Mailing Address - Zip Code: | 90048-1839 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 310-659-6889 |
| Mailing Address - Fax: | 310-657-3841 |
| Practice Address - Street 1: | 8737 BEVERLY BLVD STE 303 |
| Practice Address - Street 2: | |
| Practice Address - City: | WEST HOLLYWOOD |
| Practice Address - State: | CA |
| Practice Address - Zip Code: | 90048-1839 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 310-659-6889 |
| Practice Address - Fax: | 310-657-3841 |
| Is Sole Proprietor?: | Yes |
| Enumeration Date: | 2006-12-05 |
| Last Update Date: | 2016-03-15 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| CA | G53861 | 207X00000X, 207XX0005X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 207XX0005X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine |
| No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| CA | 00G538610 | Medicaid | |
| ED2743 | Medicare UPIN | ||
| CA | 00G538610 | Medicaid |