Provider Demographics
NPI:1376924779
Name:KLEEN, STEVEN MATTHEW (OD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MATTHEW
Last Name:KLEEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 MAYRUM ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-2719
Mailing Address - Country:US
Mailing Address - Phone:805-722-4748
Mailing Address - Fax:
Practice Address - Street 1:701 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-2829
Practice Address - Country:US
Practice Address - Phone:805-737-1826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-11
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15248152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist