Provider Demographics
NPI:1174562722
Name:PERKINS, KIMBERLY H (MD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:H
Last Name:PERKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6805 FIVE STAR BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95677-4135
Mailing Address - Country:US
Mailing Address - Phone:916-624-3500
Mailing Address - Fax:916-624-3351
Practice Address - Street 1:6805 FIVE STAR BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677-4135
Practice Address - Country:US
Practice Address - Phone:916-624-3500
Practice Address - Fax:916-624-3351
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2014-10-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG70114207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF53470Medicare UPIN