Kimberly A Douglas, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

G71095 Issued in CA

Practice address

27800 Medical Center Rd
Suite 138
Mission Viejo, CA 92691-6410

Phone

(949) 365-2379

Fax

(949) 831-1920

NPI assigned

Feb 7, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• UC Regents Uci Dept of Pediatrics

  • Pediatrics Physician
  • Orange, CA
  • NPI 1235187311
  Medicare reassignment NPD
• Bristol Park Medical Group, Inc

  • Family Medicine Physician
  • Costa Mesa, CA
  • NPI 1043266760

  Pediatrics

  NPD (past)
• Neo-Perinatology Associates of Orange County

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1316165814
  NPD (past)
• University of California Irvine

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1689608150
  NPD (past)
• Kapiolani Medical Center for Women & Children

  • Children's Hospital
  • Honolulu, HI
  • NPI 1043263080
  NPD (past)

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392163200000",
    "number": "1619017670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 S MAIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683835",
            "telephone_number": "714-509-8767",
            "fax_number": "714-509-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27800 MEDICAL CENTER RD",
            "address_2": "SUITE 138",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916410",
            "telephone_number": "949-365-2379",
            "fax_number": "949-831-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2014-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G71095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronan Donnelly, PA-C
• Megan Doody
• Allison Dorman
• Dormir Anesthesia Services, Inc.
• Parshaw Jonathan Dorriz, MD
• Afshin Y Doust, M.D.
• Kayvon Ali Dowlatshahi
• Dr Alexander Ghobadimanesh PC
• Dr de Lormes Dental Group Inc
• Dr Gediz Barnar

• Pediatrics Physician in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.