Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | A124175 | CA |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | A124175 | CA |
NPI | 1578859435 |
---|---|
Provider Name | Dr. Kimberly Michele Spahn |
First Address | San Diego, CA 92115-3104 |
Second Address | San Diego, CA 92134-1098 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2011 |
Last Update Date | 22/08/2017 |