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Organization
KIMBERLEY I SHINE M D INC
Active
Organization
KIMBERLEY I SHINE M D INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLEY I SHINE MD (OWNER)
(626) 222-8636
Entity
Organization
Contact information
Practice address
960 E GREEN ST STE 206, PASADENA, CA 91106-2401
(626) 222-8636
(626) 317-0192
Mailing address
960 E GREEN ST STE 206, PASADENA, CA 91106-2401
(626) 222-8636
(626) 317-0192
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A76961
CA
Other
Enumeration date
04/18/2016
Last updated
07/15/2024
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