Provider Demographics
NPI:1760679161
Name:KLEIN, JOSEPH P (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:P
Last Name:KLEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 PINETOP LAKE ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-0922
Mailing Address - Country:US
Mailing Address - Phone:951-775-8710
Mailing Address - Fax:
Practice Address - Street 1:623 PINETOP LAKE ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89002-0922
Practice Address - Country:US
Practice Address - Phone:951-775-8710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG13326174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist