Basic Information
| Provider Information | |||||||||
| NPI: | 1144223801 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KOLAR | ||||||||
| FirstName: | KIMBERLY | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | KOLAR | ||||||||
| OtherFirstName: | KIMBERLY | ||||||||
| OtherMiddleName: | A | ||||||||
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| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3950 G.S. RICHARDS BLVD. | ||||||||
| Address2: | |||||||||
| City: | CARSON CITY | ||||||||
| State: | NV | ||||||||
| PostalCode: | 897038457 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753240699 | ||||||||
| FaxNumber: | 7758888067 | ||||||||
| Practice Location | |||||||||
| Address1: | 640 W MOANA LN | ||||||||
| Address2: | STE 2 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895094857 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753240699 | ||||||||
| FaxNumber: | 7758888067 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2005 | ||||||||
| LastUpdateDate: | 05/17/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | 8012 | NV | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.