Mark Klebanov MD Corp

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

A54480 Issued in CA

Legal business name

MARK KLEBANOV MD CORP

Practice address

120 La Casa Via Ste 102
Walnut Creek, CA 94598-3092

Phone

(925) 296-0344

Fax

(925) 947-5424

NPI assigned

Oct 16, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mark Klebanov, M.D.

Title

Doctor

Phone

(925) 296-0344

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700966686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 LA CASA VIA STE 102",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983092",
            "telephone_number": "925-296-0344",
            "fax_number": "925-947-5424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 LA CASA VIA STE 102",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983092",
            "telephone_number": "925-296-0344",
            "fax_number": "925-947-5424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK KLEBANOV MD CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KLEBANOV",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "925-296-0344",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A54480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frances Anne Yabut Mariano
• Paul Nicholas Marinos, DPM
• Allison L Maritz
• Mark David Levine, MD Walnut Creek Professional Corporation
• Mark David Levinemd, Walnut Creek, PC
• Mark R. Maher DDS, Inc.
• Sara D. Mark, MD
• Siobhan Mark, MS CCC-SLP
• Thomas Markiewith, P.A.
• Sara Marks Brown, MA

• Endocrinology, Diabetes & Metabolism Physician in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Endocrinology, Diabetes & Metabolism Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.