Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 1033421383 | CA |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 1033421383 | CA |
N | 208200000X | Surgeon | R72238 | AZ |
N | 208600000X | Surgeon | R72238 | AZ |
NPI | 1033421383 |
---|---|
Provider Name | Dr. Kimberley Berg |
First Address | Madera, CA 93636-8761 |
Second Address | Visalia, CA 93291-6237 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2010 |
Last Update Date | 21/12/2021 |