Provider Demographics
NPI:1700812856
Name:CHIMENTI, CATHERINE A (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:CHIMENTI
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 1:1750 EL CAMINO REAL STE 11
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-3208
Mailing Address - Country:US
Mailing Address - Phone:650-697-7643
Mailing Address - Fax:650-697-7895
Practice Address - Street 1:1750 EL CAMINO REAL STE 11
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3208
Practice Address - Country:US
Practice Address - Phone:650-697-7643
Practice Address - Fax:650-697-7895
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG53760207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G537600Medicaid
CA00G537600Medicare ID - Type Unspecified
CAA52590Medicare UPIN