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General NPI Number Information
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NPI Number | 1316456734
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Entity Type | Organization
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Legal Business Name | KIMBERLY ROSE DAVIS MD INC APMC
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Dates
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Enumeration Date | 09/28/2017
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Last Update Date | 09/07/2021
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Provider Practice Location Address
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Address Line | 2181 CITRACADO PARKWY
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City | ESCONDIDO
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State | CA
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Zip | 92029-4159
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Country | US
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Telephone | 442-277-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 153 SOUTH SIERRA # 1167
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City | SOLANA BEACH
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State | CA
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Zip | 92075-2050
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Country | US
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Telephone | 858-461-9866
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | KIMBERLY R DAVIS
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Credential | MD
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Telephone | 858-461-9866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | A142106
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License Number State | CA
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