Provider Demographics
NPI:1780874636
Name:EDWARD KLEIN, M.D. AMC
Entity type:Organization
Organization Name:EDWARD KLEIN, M.D. AMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-532-8124
Mailing Address - Street 1:1141 W REDONDO BEACH BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-3586
Mailing Address - Country:US
Mailing Address - Phone:310-532-8124
Mailing Address - Fax:310-532-2210
Practice Address - Street 1:1141 W REDONDO BEACH BLVD
Practice Address - Street 2:302
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-3586
Practice Address - Country:US
Practice Address - Phone:310-532-8124
Practice Address - Fax:310-532-2210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG26436207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G264360OtherMEDI-CAL
CA1346256542OtherINDIVIDUAL NPI NUMBER
CA290015209OtherRAILROAD MEDICARE
CA00G264360OtherBLUE SHIELD OF CALIFORNIA
CA198566300OtherDEPT. OF LABOR
CA00G264360OtherMEDI-CAL
CA290015209OtherRAILROAD MEDICARE