Provider Demographics
NPI:1841396876
Name:REED, KIMBERLEE MICHELE (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLEE
Middle Name:MICHELE
Last Name:REED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KIMBERLEE
Other - Middle Name:REED
Other - Last Name:GRISE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:680 GUZZI LN
Mailing Address - Street 2:SUITE #204
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-5288
Mailing Address - Country:US
Mailing Address - Phone:209-588-9788
Mailing Address - Fax:209-588-9789
Practice Address - Street 1:680 GUZZI LN
Practice Address - Street 2:SUITE #204
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-5288
Practice Address - Country:US
Practice Address - Phone:310-384-1355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA060628208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery