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NPI Code Detail

MEDICARE: KIMBERLY CAMILLE EDWARDS R.D.

MEDICARE:   KIMBERLY CAMILLE EDWARDS  R.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
1133V00000XRegistered Dietitian912518CA

General Provider Information

NPI Number : 1447691274
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY CAMILLE EDWARDS R.D.
Provider Business Mailing Address
First Line : PO BOX 858
Second Line :
City : LAKE ELSINORE
State : CA
Zip : 92531-0858
Country : US
Telephone Number : 951-330-4360
Fax Number : 888-978-4430
Provider Business Practice Location Address
First Line : 3610 CENTRAL AVE
Second Line : STE 400
City : RIVERSIDE
State : CA
Zip : 92506-5907
Country : US
Telephone Number : 951-330-4360
Fax Number : 888-978-4430
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2013
Last Update Date : 02/19/2022

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Directions to “ KIMBERLY CAMILLE EDWARDS R.D.” Practice Location

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