Basic Information
| Provider Information | |||||||||
| NPI: | 1952545220 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KIMBLE | ||||||||
| FirstName: | ALEXIS | ||||||||
| MiddleName: | MAY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 542 S FAIR OAKS AVE FL 2 | ||||||||
| Address2: | |||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911052606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 1626535083 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 542 S FAIR OAKS AVE FL 2 | ||||||||
| Address2: | |||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6265350832 | ||||||||
| FaxNumber: | 6265350842 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2009 | ||||||||
| LastUpdateDate: | 12/29/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 20A16663 | CA | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207VG0400X | 20A16663 | CA | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology | 2088F0040X | 36132170 | IL | N | Allopathic & Osteopathic Physicians | Urology | Female Pelvic Medicine and Reconstructive Surgery | 2088F0040X | 286040 | NY | N | Allopathic & Osteopathic Physicians | Urology | Female Pelvic Medicine and Reconstructive Surgery | 207VF0040X | 20A16663 | CA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Female Pelvic Medicine and Reconstructive Surgery |
No ID Information.