Provider Demographics
NPI:1851484968
Name:LINARES, KIM G (MD)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:G
Last Name:LINARES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34092 CHULA VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-2533
Mailing Address - Country:US
Mailing Address - Phone:949-240-0171
Mailing Address - Fax:
Practice Address - Street 1:34092 CHULA VISTA AVE
Practice Address - Street 2:
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-2533
Practice Address - Country:US
Practice Address - Phone:949-240-0171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG38193207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
F9057Medicare UPIN