Provider Demographics
NPI:1558474866
Name:KIMELMAN, ALAN B (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:B
Last Name:KIMELMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 312
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-0609
Mailing Address - Country:US
Mailing Address - Phone:415-408-3500
Mailing Address - Fax:415-408-3365
Practice Address - Street 1:4 FLORIDA ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-5028
Practice Address - Country:US
Practice Address - Phone:415-408-3500
Practice Address - Fax:415-408-3365
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG493582081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA51340Medicare UPIN