Healthcare Provider Details

I. General information

NPI: 1093847022
Provider Name (Legal Business Name): LEIGH S. KIMBERG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PIERCE ST MAXINE HALL HEALTH CENTER
SAN FRANCISCO CA
94115-4005
US

IV. Provider business mailing address

1301 PIERCE ST MAXINE HALL HEALTH CENTER
SAN FRANCISCO CA
94115-4005
US

V. Phone/Fax

Practice location:
  • Phone: 415-292-1300
  • Fax: 415-928-6487
Mailing address:
  • Phone: 415-292-1300
  • Fax: 415-928-6487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberG76137
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: