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General NPI Number Information
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NPI Number | 1346344702
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Entity Type | Individual
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Provider Name | KIMBERLY ELLEN MINESINGER D.O
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Gender | Female
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 04/06/2021
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Provider Practice Location Address
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Address Line | 1820 FULLERTON AVE STE 115
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City | CORONA
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State | CA
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Zip | 92881-3160
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Country | US
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Telephone | 951-817-5000
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Fax | 951-817-5002
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Provider Business Mailing Address
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Address Line | 1901 TOWN AND COUNTRY DR STE. 104
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City | NORCO
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State | CA
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Zip | 92860-3611
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A7484
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | 20A7484
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License Number State | CA
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