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General NPI Number Information
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NPI Number | 1437748191
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Entity Type | Individual
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Provider Name | MAXWELL LAMBERT KIMBERLEY-BRYANT PA-C
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Gender | Male
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Dates
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Enumeration Date | 01/15/2021
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 10089 WILLOW CREEK RD STE 200
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City | SAN DIEGO
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State | CA
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Zip | 92131-1699
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Country | US
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Telephone | 858-621-1514
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Fax | 858-585-4070
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Provider Business Mailing Address
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Address Line | 10089 WILLOW CREEK RD STE 200
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City | SAN DIEGO
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State | CA
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Zip | 92131-1699
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Country | US
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Telephone | 858-621-1514
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Fax | 585-585-4070
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA2442
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 62817
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License Number State | CA
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