Provider Demographics
NPI:1932246691
Name:KLEIN, DEBORAH ANNE (MS, RD)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:ANNE
Last Name:KLEIN
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8111 BEVERLY BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-4525
Mailing Address - Country:US
Mailing Address - Phone:310-247-0018
Mailing Address - Fax:
Practice Address - Street 1:8111 BEVERLY BLVD
Practice Address - Street 2:SUITE 208
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-4525
Practice Address - Country:US
Practice Address - Phone:310-247-0018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA814732133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMNT814732Medicare ID - Type Unspecified