Provider Demographics
NPI:1215001771
Name:KLOMPUS, ANDREW HENRY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:HENRY
Last Name:KLOMPUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2100 WEBSTER ST
Mailing Address - Street 2:314
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2373
Mailing Address - Country:US
Mailing Address - Phone:415-923-3031
Mailing Address - Fax:415-346-5792
Practice Address - Street 1:2100 WEBSTER ST
Practice Address - Street 2:314
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2373
Practice Address - Country:US
Practice Address - Phone:415-923-3031
Practice Address - Fax:415-346-5792
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAO614232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG90983Medicare UPIN
CA00A614230Medicare ID - Type UnspecifiedTHO NO LONGER W MEDICARE