MEDICARE: DR. KIMBERLY JEAN DUIR 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
1	207Q00000X	Family Medicine Physician	55601	MA
2	207Q00000X	Family Medicine Physician	G57232	CA

General Provider Information

NPI Number	:	1578646998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMBERLY JEAN DUIR MD

Provider Business Mailing Address
First Line	:	1818 ACTON ST
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94702-1516
Country	:	US
Telephone Number	:	510-220-8643
Fax Number	:

Provider Business Practice Location Address
First Line	:	2031 6TH ST
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94710-2006
Country	:	US
Telephone Number	:	151-022-0864
Fax Number	:

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

Provider Enumeration Date	:	10/21/2006
Last Update Date	:	03/21/2018

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