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General NPI Number Information
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NPI Number | 1548492549
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Entity Type | Organization
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Legal Business Name | ALAN BRENNER KIMELMAN MD INC
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Dates
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Enumeration Date | 08/10/2009
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Last Update Date | 08/10/2009
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Provider Practice Location Address
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Address Line | 750 LAS GALLINAS AVE
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City | SAN RAFAEL
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State | CA
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Zip | 94903-3438
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Country | US
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Telephone | 415-485-4463
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Fax | 415-721-7954
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Provider Business Mailing Address
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Address Line | PO BOX 488
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City | KENTFIELD
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State | CA
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Zip | 94914-0488
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Country | US
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Telephone | 415-485-4463
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Fax | 415-721-7954
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALAN KIMELMAN
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Credential | MD
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Telephone | 415-485-4463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | G49358
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License Number State | CA
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