Provider Demographics
NPI:1386023760
Name:KLEIN, DANA MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:MICHAEL
Last Name:KLEIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:DANE
Other - Middle Name:MICHAEL
Other - Last Name:KLEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:130 SUTTER ST FL 2
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-4009
Mailing Address - Country:US
Mailing Address - Phone:415-658-6791
Mailing Address - Fax:415-520-0904
Practice Address - Street 1:2196 E WILLIAMS FIELD RD STE 116
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-0755
Practice Address - Country:US
Practice Address - Phone:480-237-1395
Practice Address - Fax:602-218-4076
Is Sole Proprietor?:No
Enumeration Date:2015-05-19
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR3076204D00000X
390200000X
AZ007693207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program