Individual
KIMBERLY BRAYTON BRAYTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3536 MENDOCINO AVE, STE 200, SANTA ROSA, CA 95403-3648
(707) 573-6166
(707) 573-6165
Mailing address
3536 MENDOCINO AVE, STE 200, SANTA ROSA, CA 95403-3648
(707) 573-6166
(707) 573-6165
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A106242
CA
207RC0000X
Cardiovascular Disease Physician
Primary
A106242
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0A1062420
BLUE SHIELD OF CALIFORNIA
CA
01
—
P01609287
RAILROAD MEDICARE
CA
Enumeration date
08/03/2009
Last updated
01/10/2022
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