Robert T. Kimura D.M.D.
Exclusive Provider Organization in Los Angeles, CA. Organization (NPI-2).
NPI number1720205891
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1720205891
- Entity type
- Organization (NPI-2)
- Legal business name
- Robert T. Kimura D.M.D.
- Organization subpart
- No
- Enumeration date
- Apr 19, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 302F00000X | Exclusive Provider Organization | – | – | Yes |
Practice location
11980 San Vicente Blvd Ste 500Los Angeles, CA 90049-6603
Phone 310-207-6111 · Fax 310-207-8083
Mailing address
11980 San Vicente Blvd Ste 500Los Angeles, CA 90049-6603
Phone 310-207-6111 · Fax 310-207-8083
Authorized official
Robert T. Kimura
Dr.
3102076111
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