Shepard, Kimberly G
Shepard, Kimberly G is an individual health care provider with primary practice located at 751 S Bascom Ave Ent Clinic, San Jose CA 95128-2604. She recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as her primary health care specialty. Shepard, Kimberly G can be contacted via phone (408) 885-6767.Contact Information
Primary practice address
751 S Bascom Ave Ent Clinic
San Jose CA 95128-2604
Phone: (408) 885-6767
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | G75979 | California |
Profile Details
| NPI number | 1720183395 |
|---|---|
| LBN Legal business name | Shepard, Kimberly G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 14th, 2006 |
| Last updated | Sep 12th, 2007 - about 18 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 | 1720183395 | NPPES |
| California | MEDICAID | 00G759790 |
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