Basic Information
| Provider Information | |||||||||
| NPI: | 1982822425 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KLEMAN | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 655 LAGUNA DRIVE | ||||||||
| Address2: | |||||||||
| City: | CARLSBAD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920083730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607297101 | ||||||||
| FaxNumber: | 7607297106 | ||||||||
| Practice Location | |||||||||
| Address1: | 655 LAGUNA DR | ||||||||
| Address2: | |||||||||
| City: | CARLSBAD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920081610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607297101 | ||||||||
| FaxNumber: | 7607297106 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/22/2007 | ||||||||
| LastUpdateDate: | 01/18/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 13387 | CA | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.