Provider Demographics
NPI:1619272028
Name:KLEEMAN, SUSAN T (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:T
Last Name:KLEEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6344 MUIRLANDS DR
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-6352
Mailing Address - Country:US
Mailing Address - Phone:858-459-3685
Mailing Address - Fax:
Practice Address - Street 1:6344 MUIRLANDS DR
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-6352
Practice Address - Country:US
Practice Address - Phone:858-459-3685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-14
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG114512084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine