Organization
MARK KLEBANOV MD CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK KLEBANOV M.D. (DOCTOR)
(925) 296-0344
Entity
Organization
Contact information
Practice address
120 LA CASA VIA STE 102, WALNUT CREEK, CA 94598-3092
(925) 296-0344
(925) 947-5424
Mailing address
120 LA CASA VIA STE 102, WALNUT CREEK, CA 94598-3092
(925) 296-0344
(925) 947-5424
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
A54480
CA
Other
Enumeration date
10/16/2006
Last updated
08/22/2020
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