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General NPI Number Information
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NPI Number | 1437350808
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Entity Type | Individual
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Provider Name | KIMBERLY CHRISTINA IZVERNARI-IM M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 03/25/2019
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Provider Practice Location Address
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Address Line | 2 W FERN AVE
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City | REDLANDS
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State | CA
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Zip | 92373-5916
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Country | US
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Telephone | 909-793-3311
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Fax |
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Provider Business Mailing Address
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Address Line | 1615 ORANGE TREE LN
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City | REDLANDS
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State | CA
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Zip | 92374-4501
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Country | US
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Telephone | 909-786-0725
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A97432
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License Number State | CA
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