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NPI Code Detail

MEDICARE: DR. KIMBERLY A FITZGERALD M.D.

MEDICARE: DR. KIMBERLY A FITZGERALD M.D.
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
12084A0401XAddiction Medicine (Psychiatry & Neurology) PhysicianA132788CA
22084A0401XAddiction Medicine (Psychiatry & Neurology) Physician68771GA

General Provider Information

NPI Number : 1750525267
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KIMBERLY A FITZGERALD M.D.
Provider Business Mailing Address
First Line : 3420 KENYON ST
Second Line : BUILDING B, FIRST FLOOR
City : SAN DIEGO
State : CA
Zip : 92110-5001
Country : US
Telephone Number : 619-221-6050
Fax Number :
Provider Business Practice Location Address
First Line : 3420 KENYON ST
Second Line : BUILDING B, FIRST FLOOR
City : SAN DIEGO
State : CA
Zip : 92110-5001
Country : US
Telephone Number : 619-221-6050
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2009
Last Update Date : 05/04/2026

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