Basic Information
Provider Information
NPI: 1982775144
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KLING
FirstName: KAREN
MiddleName: MICHIKO
NamePrefix: MS.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3860 CALLE FORTUNADA
Address2: STE #210
City: SAN DIEGO
State: CA
PostalCode: 921234802
CountryCode: US
TelephoneNumber: 8583096303
FaxNumber: 8583096301
Practice Location
Address1: 8010 FROST ST STE 414
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921234235
CountryCode: US
TelephoneNumber: 8589667711
FaxNumber: 8589667712
Other Information
ProviderEnumerationDate: 11/10/2006
LastUpdateDate: 12/12/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000XA53583CAN Allopathic & Osteopathic PhysiciansSurgery 
2086S0120XA53583CAY Allopathic & Osteopathic PhysiciansSurgeryPediatric Surgery

No ID Information.


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