Provider Demographics
NPI:1881743383
Name:KLEIN, JEFFREY HOWARD (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:HOWARD
Last Name:KLEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16830 VENTURA BLVD
Mailing Address - Street 2:SUITE 315
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-1707
Mailing Address - Country:US
Mailing Address - Phone:800-757-4242
Mailing Address - Fax:818-971-3580
Practice Address - Street 1:16830 VENTURA BLVD
Practice Address - Street 2:SUITE 315
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-1707
Practice Address - Country:US
Practice Address - Phone:800-757-4242
Practice Address - Fax:818-971-3580
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG24094207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA-42158Medicare UPIN