Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ND113 | CA |
NPI | 1144418658 |
---|---|
Provider Name | Dr. Eric C Kimbles |
First Address | Sonoma, CA 95476-6811 |
Second Address | Sonoma, CA 95476-6811 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2007 |
Last Update Date | 09/10/2007 |