Healthcare Provider Details

I. General information

NPI: 1013968361
Provider Name (Legal Business Name): KIMBERLY ANN DREHER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIMBERLY ANN THOMPSON DO

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 05/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3667 SEDLOCK DR
CORONA CA
92881-8434
US

IV. Provider business mailing address

3667 SEDLOCK DR
CORONA CA
92881-8434
US

V. Phone/Fax

Practice location:
  • Phone: 951-343-3481
  • Fax: 951-343-3486
Mailing address:
  • Phone: 951-343-3481
  • Fax: 951-343-3486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20A8203
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: