Provider Demographics
NPI:1578646998
Name:DUIR, KIMBERLY JEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:JEAN
Last Name:DUIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 ACTON ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94702-1516
Mailing Address - Country:US
Mailing Address - Phone:510-220-8643
Mailing Address - Fax:
Practice Address - Street 1:2031 6TH ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94710-2006
Practice Address - Country:US
Practice Address - Phone:151-022-0864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA55601207Q00000X
CAG57232207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine