YEVGENY KLEBANOV (NPI# 1841555976) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841555976 |
| Entity Type | Individual |
| Full Name | YEVGENY KLEBANOV |
| Credential | M.D. |
| Practice Address |
120 La Casa Via Ste 101 Walnut Creek CA 94598-3092 |
| Mailing Address |
1400 Broadway Unit 1401 San Diego CA 92101-5744 |
| Practice Telephone | 9252960344 |
| Practice Fax Number | 9259475424 |
| Enumeration Date | 2012-07-04 |
| Last Update Date | 2018-05-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | A126559 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
120 LA CASA VIA STE 101 |
| City | WALNUT CREEK |
| State | CA |
| Zip Code | 94598-3092 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689176232 | Primary Care of Walnut Creek | Internal Medicine | 120 La Casa Via Ste 101, Walnut Creek, CA 94598-3092 | 2018-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639716608 | Tasnim Diaf Moulton | Counselor | 2730 Shadelands Drive, Walnut Creek, CA 94598 | 2019-12-09 |
| 1790255370 | Harmony Grace Davis | Behavior Technician | 2730 Shadelands Drive Bldg 10, Walnut Creek, CA 94598 | 2018-11-27 |
| 1922583772 | Melissa Anne Mcgovern | Behavioral Analyst | 2370 Shadelands Drive, Bldg 10, Walnut Creek, CA 94598 | 2018-09-27 |
| 1184108367 | Brett Heflin Woodrufff | Behavior Technician | 2730 Shandeland Dr. Building 10, Walnut Creek, CA 94598 | 2018-09-24 |
| 1710411640 | Mandy Wei | Pharmacist | 2880 Shadeland Dr, Suite 201, Walnut Creek, CA 94598 | 2017-04-18 |
| 1437683497 | Hayley Miller | Student in an Organized Health Care Education/Training Program | 2204 Lomond Lane, Walnut Creek, CA 94598 | 2017-04-17 |
| 1043601594 | Marlene Perez Riedel | Nurse Practitioner | 450 North Wiget Lane, Walnut Creek, CA 94598 | 2015-02-05 |
| 1922418904 | Dante Michael Sorrentino | Ophthalmology | Kaiser Permanente Park Shadelands Medical Offices, 320 Lennon Lane, Walnut Creek, CA 94598 | 2014-04-30 |
| 1194156505 | Robert Harrison Hubbell | Obstetrics & Gynecology | 838 Stonehaven Dr, Walnut Creek, CA 94598 | 2013-12-11 |
| 1174954192 | Paul Mead | Orthopaedic Surgery | 2405 Shadelands Dr Ste 300, Walnut Creek, CA 94598 | 2013-12-01 |
| Find all providers in zip 94598 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154733152 | Zachary Thomas Fellows | Internal Medicine | 120 La Casa Via Ste 204, Walnut Creek, CA 94598-3007 | 2014-05-24 |
| 1063764488 | Baldomero De Leon M.d. Inc. | Internal Medicine | 1479 Ygnacio Valley Rd Ste 201, Walnut Creek, CA 94598-2945 | 2012-10-09 |
| 1184910390 | Gisha Thomas | Internal Medicine | 3466 Mt. Diablo Blvd, #c104, Walnut Creek, CA 94596 | 2011-06-27 |
| 1831497437 | Ronald G Campos, Md Inc | Internal Medicine | 1844 San Miguel Dr Ste 307, Walnut Creek, CA 94596-4963 | 2011-03-05 |
| 1083842199 | Chetachi A Okereke | Internal Medicine | 1840 San Miguel Dr, Suite 203, Walnut Creek, CA 94596-8602 | 2009-06-26 |
| 1972750123 | Syed Khalid Mustafa | Internal Medicine | 1299 Newell Hill Pl Ste 100, Walnut Creek, CA 94596-5230 | 2008-08-19 |
| 1366613390 | Leonard M. Saputo, Md Inc | Internal Medicine | 1620 Riviera Ave, Walnut Creek, CA 94596-3528 | 2008-03-18 |
| 1700085412 | Activa Medical Center, Inc. | Internal Medicine | 1479 Ygnacio Valley Rd Ste 207, Walnut Creek, CA 94598-2945 | 2007-07-12 |
| 1750433587 | Monica Ruiz Durant | Internal Medicine | 3356 Westport Ct, Walnut Creek, CA 94598-4030 | 2007-01-18 |
| 1497821276 | Elizabeth C. Seet | Internal Medicine | 1210 Rossmoor Pkwy, Walnut Creek, CA 94595-2501 | 2006-11-25 |
| Find all providers in WALNUT CREEK | ||||
| City | WALNUT CREEK |
| Zip Code | 94598 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.