Provider Demographics
NPI:1417113168
Name:LEEK, KIMBERLY B (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:B
Last Name:LEEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:B
Other - Last Name:HOUKOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3860 CALLE FORTUNADA
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4802
Mailing Address - Country:US
Mailing Address - Phone:858-502-1135
Mailing Address - Fax:858-636-4319
Practice Address - Street 1:7910 FROST ST.
Practice Address - Street 2:SUITE 350
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2753
Practice Address - Country:US
Practice Address - Phone:858-496-4800
Practice Address - Fax:858-496-4850
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-01
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA99997208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics