MEDICARE: DR. MELISSA M KIMURA PHARMD

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	183500000X	Pharmacist	RPH78694	CA

General Provider Information

NPI Number	:	1710595871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELISSA M KIMURA PHARMD

Provider Business Mailing Address
First Line	:	6 PASEO LINARES
Second Line	:
City	:	MORAGA
State	:	CA
Zip	:	94556-2101
Country	:	US
Telephone Number	:	559-273-3552
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 DNA WAY
Second Line	:
City	:	SOUTH SAN FRANCISCO
State	:	CA
Zip	:	94080-4990
Country	:	US
Telephone Number	:	650-534-4881
Fax Number	:

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

Provider Enumeration Date	:	07/15/2020
Last Update Date	:	07/15/2020

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