Individual provider Active NPI

Kimi Nicole Verilhac, M.D.

  • Forensic Pathology Physician
  • San Diego, CA
National Provider Identifier
1104115930
Registry record updated Dec 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic Pathology PhysicianTaxonomy code 207ZF0201X
License
A134515 Issued in CA
Practice address
5570 Overland Ave Ste 101
San Diego, CA 92123-1215
Phone
(858) 694-2895
NPI assigned
Apr 1, 2011
Last updated
Dec 3, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Pathology Physician 207ZF0201X A134515 CA Primary

Addresses

Primary practice location

5570 Overland Ave Ste 101
San Diego, CA 92123-1215

Mailing address

5029 Harville Rd
Santa Rosa, CA 95409-2517
Phone (970) 290-3099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A134515CAMDForensic Pathology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480723200000",
    "number": "1104115930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5029 HARVILLE RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954092517",
            "telephone_number": "970-290-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5570 OVERLAND AVE STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231215",
            "telephone_number": "858-694-2895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERILHAC",
        "first_name": "KIMI",
        "middle_name": "NICOLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-01",
        "last_updated": "2016-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZF0201X",
            "taxonomy_group": "",
            "desc": "Pathology, Forensic Pathology",
            "state": "CA",
            "license": "A134515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.