Provider Demographics
NPI:1952545220
Name:KIMBLE, ALEXIS MAY (DO)
Entity type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:MAY
Last Name:KIMBLE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:542 S FAIR OAKS AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2606
Mailing Address - Country:US
Mailing Address - Phone:162-653-5083
Mailing Address - Fax:
Practice Address - Street 1:542 S FAIR OAKS AVE FL 2
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105
Practice Address - Country:US
Practice Address - Phone:626-535-0832
Practice Address - Fax:626-535-0842
Is Sole Proprietor?:No
Enumeration Date:2009-04-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A16663207V00000X, 207VG0400X, 207VF0040X
IL361321702088F0040X
NY2860402088F0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No2088F0040XAllopathic & Osteopathic PhysiciansUrologyUrogynecology and Reconstructive Pelvic Surgery