Provider Demographics
NPI:1154070084
Name:KLEIMAN HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:KLEIMAN HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NAZENEEM
Authorized Official - Middle Name:S
Authorized Official - Last Name:KLEIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:310-951-3450
Mailing Address - Street 1:415 N STATE ST STE 136
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-3243
Mailing Address - Country:US
Mailing Address - Phone:310-951-3450
Mailing Address - Fax:
Practice Address - Street 1:415 N STATE ST STE 136
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97034-3243
Practice Address - Country:US
Practice Address - Phone:310-951-3450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-19
Last Update Date:2022-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1497396899Medicaid