# CHARLENE V. KAKIMOTO, MD, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083104012
- **Authorized official:** SIRENA FERGUSON (OFFICE MANAGER)
- **Authorized official phone:** (619) 437-1146

## Contact information

- **Practice address:** 230 PROSPECT PL STE 260, CORONADO, CA 92118-1987
- **Practice address phone:** (619) 437-1146
- **Practice address fax:** (619) 437-1912
- **Mailing address:** 230 PROSPECT PL STE 260, CORONADO, CA 92118-1987
- **Mailing address phone:** (619) 437-1146
- **Mailing address fax:** (619) 437-1912

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207NI0002X | Clinical & Laboratory Dermatological Immunology Physician | A82481 | CA | Yes |

## Other

- **Enumeration date:** 05/15/2018
- **Last updated:** 05/15/2018