Kimdoc LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

6782 Issued in CA

Legal business name

KIMDOC LLC

Practice address

85 Sierra Park Rd
Mammoth Lakes, CA 93546-2073

Phone

(310) 994-2822

NPI assigned

Jun 30, 2014

Last updated

Jun 30, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kevin I Metzger, D.O.NPI 1689847725

Title

Owner

Phone

(310) 994-2822

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin Metzger, DO

  • Family Medicine Physician
  • Rancho Cucamonga, CA
  • NPI 1689847725
  Authorized official Same address or phone

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404086400000",
    "number": "1952716722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 OCEAN PARK BLVD",
            "address_2": "107-4442",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904053301",
            "telephone_number": "310-994-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 SIERRA PARK RD",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "935462073",
            "telephone_number": "310-994-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMDOC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-30",
        "last_updated": "2014-06-30",
        "status": "A",
        "authorized_official_last_name": "METZGER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-994-2822",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "6782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Intouch Microspa
• Nancy Ellen Johnson
• Richard Owen Johnson, MD
• Michael Karch, M.D.
• Grace Charmie Kim, MD, MPP
• Aleksandras Kirsonis, PHARMD
• Robert Kocher
• Lorraine Koenig, PHYSICAL THERAPIST
• Carolyn Korfiatis, FNP-BC
• Julian Kuettner

• Family Medicine Physician in Mammoth Lakes, CA
• Providers in Mammoth Lakes, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2014; 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.