MEDICARE: CHARLENE V. KAKIMOTO, MD, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207NI0002X	Clinical & Laboratory Dermatological Immunology Physician	A82481	CA

General Provider Information

NPI Number	:	1083104012
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHARLENE V. KAKIMOTO, MD, INC

Provider Business Mailing Address
First Line	:	230 PROSPECT PL STE 260
Second Line	:
City	:	CORONADO
State	:	CA
Zip	:	92118-1987
Country	:	US
Telephone Number	:	619-437-1146
Fax Number	:	619-437-1912

Provider Business Practice Location Address
First Line	:	230 PROSPECT PL STE 260
Second Line	:
City	:	CORONADO
State	:	CA
Zip	:	92118-1987
Country	:	US
Telephone Number	:	619-437-1146
Fax Number	:	619-437-1912

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	SIRENA FERGUSON
Credential	:
Telephone Number	:	619-437-1146

Provider Enumeration Date	:	05/15/2018
Last Update Date	:	05/15/2018

Similar Medicare Providers

1124021779 — DR. NANCY B. MURRAY M.D.
Practice Location Address:

230 PROSPECT PL , STE 260
CORONADO, CA
92118-1987

Practice Phone: 619-437-1146
Practice Fax: 619-437-1912

1649273293 — DR. D. A. LOPEZ M.D.
Practice Location Address:

230 PROSPECT PL , STE 260
CORONADO, CA
92118-1987

Practice Phone: 619-437-1146
Practice Fax: 619-437-1912

1619467628 — CHARLENE V. KAKIMOTO, MD, INC
Practice Location Address:

230 PROSPECT PL STE 260
CORONADO, CA
92118-1987

Practice Phone: 619-437-1146
Practice Fax:

1326603028 — JACQUELINE BROGAN MD
Practice Location Address:

230 PROSPECT PL STE 260
CORONADO, CA
92118-1987

Practice Phone: 619-437-1146
Practice Fax:

1306935200 — D.A. LOPEZ, MD
Practice Location Address:

230 PROSPECT PL , SUITE 260
CORONADO, CA
92118-1978

Practice Phone: 619-437-1146
Practice Fax: 619-437-1912

1437092111 — JILL COLLINS RN
Practice Location Address:

1350 LEYTE RD
CORONADO, CA
92118-3124

Practice Phone: 619-522-8934
Practice Fax:

Directions to “CHARLENE V. KAKIMOTO, MD, INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.