Healthcare Provider Details

I. General information

NPI: 1568758043
Provider Name (Legal Business Name): KIRSTEN E.J. LIMMER MD, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2011
Last Update Date: 05/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 FIR ST
SAN DIEGO CA
92101-2327
US

IV. Provider business mailing address

10243 GENETIC CENTER DR
SAN DIEGO CA
92121-6310
US

V. Phone/Fax

Practice location:
  • Phone: 858-499-2701
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA132358
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: