Provider Demographics
NPI:1073710489
Name:BEKEMEIER, KIMBERLY ANNE (DO)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANNE
Last Name:BEKEMEIER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:18564 US HIGHWAY 18 STE 105
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2320
Mailing Address - Country:US
Mailing Address - Phone:760-242-7777
Mailing Address - Fax:760-242-2658
Practice Address - Street 1:13010 HESPERIA RD
Practice Address - Street 2:SUITE 600
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-5837
Practice Address - Country:US
Practice Address - Phone:760-881-3717
Practice Address - Fax:760-881-3720
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A10741207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine