Individual provider Active NPI

Maxwell Lambert Kimberley-Bryant, PA-C

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1437748191
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
62817 Issued in CA
Practice address
10089 Willow Creek Rd Ste 200
San Diego, CA 92131-1699
Phone
(858) 621-1514
Fax
(858) 585-4070
NPI assigned
Jan 15, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2442 NV
Physician Assistant 363A00000X 62817 CA Primary

Addresses

Primary practice location

10089 Willow Creek Rd Ste 200
San Diego, CA 92131-1699

Mailing address

10089 Willow Creek Rd Ste 200
San Diego, CA 92131-1699
Phone (858) 621-1514

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230714002920 CA Practitioner - Physician Assistant 1557779436 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 E Huntington Dr
Suite 209
Alhambra, CA 91801-1022

1489 NW 4TH Ave
Ontario, OR 97914-1485

PO Box
Suite 2589
San Gabriel, CA 91778

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
62817CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Doc Integrated Med, PC CurrentSince Mar 2, 2026 Accepting new patients
J M Geiss DO Apc CurrentSince Mar 2, 2026 Accepting new patients

Locations

5 Hutton Centre Dr
Ste 950
Santa Ana, CA 92707
Phone (855) 434-7663

Interoperability endpoints

  • Direct secure messaging: maxwell.kimberley-bryant@299395540647940.direct.elationemr.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1610668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1437748191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10089 WILLOW CREEK RD STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311699",
            "telephone_number": "858-621-1514",
            "fax_number": "585-585-4070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10089 WILLOW CREEK RD STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311699",
            "telephone_number": "858-621-1514",
            "fax_number": "858-585-4070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBERLEY-BRYANT",
        "first_name": "MAXWELL",
        "middle_name": "LAMBERT",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-15",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2442",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "62817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.