Provider Demographics
NPI:1205074903
Name:KIMBALL, PERLA FIGA (LAC)
Entity type:Individual
Prefix:MRS
First Name:PERLA
Middle Name:FIGA
Last Name:KIMBALL
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MRS
Other - First Name:PERLA
Other - Middle Name:
Other - Last Name:FIGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:15644 POMERADO RD
Mailing Address - Street 2:STE.400
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-2400
Mailing Address - Country:US
Mailing Address - Phone:858-613-0792
Mailing Address - Fax:858-613-0794
Practice Address - Street 1:15644 POMERADO RD
Practice Address - Street 2:STE.400
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2400
Practice Address - Country:US
Practice Address - Phone:858-613-0792
Practice Address - Fax:858-613-0794
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11400171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist