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NPI Code Detail

MEDICARE: KIMBERLY JILL EDDINGS-REECE MD

MEDICARE:   KIMBERLY JILL EDDINGS-REECE  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianG80753CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100G807530OTHERCAMEDI CAL

General Provider Information

NPI Number : 1073513925
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY JILL EDDINGS-REECE MD
Provider Business Mailing Address
First Line : PO BOX 1234
Second Line :
City : LAKEWOOD
State : CA
Zip : 90714-1234
Country : US
Telephone Number : 310-316-0811
Fax Number :
Provider Business Practice Location Address
First Line : 1045 W REDONDO BEACH BLVD
Second Line : SUITE 240
City : GARDENA
State : CA
Zip : 90247-4128
Country : US
Telephone Number : 310-225-2825
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2005
Last Update Date : 11/05/2012

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Directions to “ KIMBERLY JILL EDDINGS-REECE MD” Practice Location

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