Breneisen, Kimberly A
Breneisen, Kimberly A is an individual health care provider with primary practice located at 2020 Sutter Pl Suite 201, Davis CA 95616-6201. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Breneisen, Kimberly A can be contacted via phone (530) 750-5959.Contact Information
Primary practice address
2020 Sutter Pl Suite 201
Davis CA 95616-6201
Phone: (530) 750-5959
Fax: (530) 750-5960
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | G83111 | California |
Profile Details
| NPI number | 1831101997 |
|---|---|
| LBN Legal business name | Breneisen, Kimberly A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 13th, 2006 |
| Last updated | Jul 27th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831101997 | NPPES |
| California | MEDICAID | 00G831110 |
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