Charles L Kimelman, MD, Inc.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

G24368 Issued in CA

Legal business name

CHARLES L KIMELMAN, MD, INC.

Practice address

5525 Etiwanda Ave
Suite #315
Tarzana, CA 91356

Phone

(818) 881-9117

Fax

(818) 881-0714

NPI assigned

Mar 17, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Charles L. Kimelman, M.D, INC

Title

President

Phone

(818) 881-9117

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1300320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300320000000",
    "number": "1124327127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 ETIWANDA AVE",
            "address_2": "SUITE #315",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "91356",
            "telephone_number": "818-881-9117",
            "fax_number": "818-881-0714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 ETIWANDA AVE",
            "address_2": "SUITE #315",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "91356",
            "telephone_number": "818-881-9117",
            "fax_number": "818-881-0714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES L KIMELMAN, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-17",
        "last_updated": "2011-03-17",
        "status": "A",
        "authorized_official_last_name": "KIMELMAN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-881-9117",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D, INC"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G24368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2483018",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Tarzana, CA
• Providers in Tarzana, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2011; 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.