MEDICARE: KIMBERLY G SMITH GALINDO

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	163W00000X	Registered Nurse	95221027	CA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95039251	CA

General Provider Information

NPI Number	:	1396368411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY G SMITH GALINDO

Provider Business Mailing Address
First Line	:	1043 W 52ND ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90037-3511
Country	:	US
Telephone Number	:	310-908-0979
Fax Number	:

Provider Business Practice Location Address
First Line	:	1043 W 52ND ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90037-3511
Country	:	US
Telephone Number	:	310-908-0979
Fax Number	:

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

Provider Enumeration Date	:	05/22/2020
Last Update Date	:	04/13/2026

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Directions to “ KIMBERLY G SMITH GALINDO ” Practice Location

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