Healthcare Provider Details

I. General information

NPI: 1124949268
Provider Name (Legal Business Name): KEVIN T. MURPHY, MD A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12625 HIGH BLUFF DR STE 320
SAN DIEGO CA
92130-2054
US

IV. Provider business mailing address

12625 HIGH BLUFF DR STE 318
SAN DIEGO CA
92130-2054
US

V. Phone/Fax

Practice location:
  • Phone: 916-337-6457
  • Fax:
Mailing address:
  • Phone: 916-337-6457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MORGAN LEMIERE
Title or Position: CHIEF OF STAFF
Credential:
Phone: 916-337-6457