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Individual
MARTIN KIMBLE
Active
Individual
MARTIN KIMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
527057
CA
363A00000X
Physician Assistant
Primary
19051
CA
363L00000X
Nurse Practitioner
15217
CA
Other
Enumeration date
02/08/2007
Last updated
07/03/2019
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