Provider Demographics
NPI:1124027370
Name:KLEINER, DANIEL M (DPM)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:M
Last Name:KLEINER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10201 MISSION GORGE RD
Mailing Address - Street 2:SUITE K
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-3027
Mailing Address - Country:US
Mailing Address - Phone:619-449-9100
Mailing Address - Fax:619-449-0722
Practice Address - Street 1:10201 MISSION GORGE RD
Practice Address - Street 2:SUITE K
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-3027
Practice Address - Country:US
Practice Address - Phone:619-449-9100
Practice Address - Fax:619-449-0722
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2008-11-25
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
CA213ES0131X213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E15740Medicaid
CAT11001Medicare UPIN
CA0254510001Medicare NSC
CAE1574Medicare PIN