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Organization
POTOMAC HEALTH MEDICAL OF CA PC
Active
Organization
POTOMAC HEALTH MEDICAL OF CA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY A KIMMEL MD (PRESIDENT/OWNER)
(860) 282-4128
Entity
Organization
Contact information
Practice address
11 PIEDMONT ROAD, LARKSPUR, CA 94939
(860) 282-4128
Mailing address
1177 HIGH RIDGE RD, STAMFORD, CT 06905-1221
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
Other
Enumeration date
10/12/2022
Last updated
11/17/2022
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