Provider Demographics
NPI:1144418658
Name:KIMBLES, ERIC C (ND)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:C
Last Name:KIMBLES
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 ANDRIEUX ST
Mailing Address - Street 2:INTEGRATIVE MEDICINE PROGRAM
Mailing Address - City:SONOMA
Mailing Address - State:CA
Mailing Address - Zip Code:95476-6811
Mailing Address - Country:US
Mailing Address - Phone:707-494-6303
Mailing Address - Fax:
Practice Address - Street 1:347 ANDRIEUX ST
Practice Address - Street 2:
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476-6811
Practice Address - Country:US
Practice Address - Phone:707-494-6303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND113175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath