Provider Demographics
NPI:1982647392
Name:KERR, KIM MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:MARIE
Last Name:KERR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9300 CAMPUS POINT DR
Mailing Address - Street 2:M/C 7381
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1300
Mailing Address - Country:US
Mailing Address - Phone:858-657-7140
Mailing Address - Fax:858-657-7107
Practice Address - Street 1:200 W ARBOR DR
Practice Address - Street 2:M/C 8201
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-9000
Practice Address - Country:US
Practice Address - Phone:619-294-3701
Practice Address - Fax:619-543-3183
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG68491207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G684910Medicaid
CAWG68491B, WG68491LMedicare ID - Type Unspecified
E13055Medicare UPIN