Provider Demographics
NPI:1154315331
Name:MARQUIS, KIMBERLEY A (MD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLEY
Middle Name:A
Last Name:MARQUIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:411 30TH ST
Mailing Address - Street 2:SUITE 314
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3312
Mailing Address - Country:US
Mailing Address - Phone:510-465-6800
Mailing Address - Fax:510-268-0634
Practice Address - Street 1:411 30TH ST
Practice Address - Street 2:SUITE 314
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3312
Practice Address - Country:US
Practice Address - Phone:510-465-6800
Practice Address - Fax:510-268-0634
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2016-01-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA92533207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA42365Medicare UPIN