Mark Klebanov, M.D.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

A54480 Issued in CA

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

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861572703",
    "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": {
        "last_name": "KLEBANOV",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A54480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Kitts
• Andrew Atkinson Kives, M.D.
• Kla Audiology Services, Inc.
• Andrie Klass, MS, CGC
• Ian Christopher Klause, RADT
• Yevgeny Klebanov, M.D.
• Karen Lee Kleckner, M.A., L.M.F.T.
• Debra Ann Klein, RNC, MSN, NP
• Kimberly Ann Klein, M.D.
• Louis Arthur Klein, M.D.

• 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 Jul 8, 2007; 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.