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General NPI Number Information
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NPI Number | 1467533596
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Entity Type | Individual
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Provider Name | KIMBERLY LYNN LOPIPERO PA
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Gender | Female
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5575 RUFFIN RD STE 100
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City | SAN DIEGO
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State | CA
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Zip | 92123-1361
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Country | US
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Telephone | 858-565-1300
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Fax | 858-565-6932
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Provider Business Mailing Address
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Address Line | 3966 LAMONT ST
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City | SAN DIEGO
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State | CA
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Zip | 92109
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Country | US
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Telephone | 585-259-1037
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 18448
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 009862-1
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License Number State | NY
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