Individual
DR. KIMBERLY K SHEKER-DICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1628 PALM AVE, SAN DIEGO, CA 92154-1027
(619) 591-9999
Mailing address
1628 PALM AVE BAY URGENT, SAN DIEGO, CA 92154-1027
(619) 591-9999
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
20A7995
CA
207P00000X
Emergency Medicine Physician
4055
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
867640
—
AZ
01
—
CB244891
MEDICARE
CA
05
—
XPY199939
—
AZ
Enumeration date
07/04/2006
Last updated
01/16/2019
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