Provider Demographics
NPI:1568017796
Name:KIMURA, ALEXI MICHIKO (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALEXI
Middle Name:MICHIKO
Last Name:KIMURA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27232
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-7232
Mailing Address - Country:US
Mailing Address - Phone:559-801-7848
Mailing Address - Fax:
Practice Address - Street 1:1035 CAMBRIDGE ST STE 23
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02141-1154
Practice Address - Country:US
Practice Address - Phone:617-801-8547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH238946183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist