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

Last updated

Aug 22, 2020By the provider in NPPES

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.NPI 1861572703

Title

Doctor

Phone

(925) 296-0344

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark Klebanov, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Walnut Creek, CA
  • NPI 1861572703
  Authorized official Same address or phone

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 (Community Psychiatry Associates)
• 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.