MEDICARE: PATRICIA LYNN KEMBERLING M.D.

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
1	174400000X	Specialist	G49873	CA

General Provider Information

NPI Number	:	1164463006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA LYNN KEMBERLING M.D.

Provider Business Mailing Address
First Line	:	866 PLUMAS ST
Second Line	:	SUITE D
City	:	YUBA CITY
State	:	CA
Zip	:	95991-4022
Country	:	US
Telephone Number	:	530-790-7712
Fax Number	:	530-790-7719

Provider Business Practice Location Address
First Line	:	866 PLUMAS ST
Second Line	:	SUITE D
City	:	YUBA CITY
State	:	CA
Zip	:	95991-4022
Country	:	US
Telephone Number	:	530-790-7712
Fax Number	:	530-790-7719

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	02/21/2008

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