Provider Demographics
NPI:1659443554
Name:KLEINHANS, ROBERT H (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:H
Last Name:KLEINHANS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13955 MONO WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-2832
Mailing Address - Country:US
Mailing Address - Phone:209-532-3700
Mailing Address - Fax:209-532-4913
Practice Address - Street 1:13955 MONO WAY
Practice Address - Street 2:SUITE A
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-2832
Practice Address - Country:US
Practice Address - Phone:209-532-3700
Practice Address - Fax:209-532-4913
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17730111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA77-0364813OtherCORPORATE TAX ID NUMBER
CA17730Medicare UPIN
CA77-0364813OtherCORPORATE TAX ID NUMBER