Individual
KIMBERLY A PECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
550 WASHINGTON ST STE 641, SAN DIEGO, CA 92103-2229
(619) 299-2600
(619) 299-3923
Mailing address
550 WASHINGTON ST STE 641, SAN DIEGO, CA 92103-2229
(619) 299-2600
(619) 299-3923
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
33630
AZ
2086S0127X
Trauma Surgery Physician
33630
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
954075
—
AZ
Enumeration date
10/17/2006
Last updated
08/20/2014
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