MARILYN H. KIMURA M.D.
NPI 1396876264
Psychiatry & Neurology - Child & Adolescent Psychiatry in San Bernardino, CA

Q: What is Marilyn Kimura's NPI number?

The NPI number for Marilyn Kimura is 1396876264. It was assigned to this individual provider in the NPPES registry on March 9, 2007.

Q: What is Marilyn Kimura's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Q: When was this NPI record last updated?

The NPPES record for Marilyn Kimura was last updated on September 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 09, 2007PECOS Enrolled

303 E VANDERBILT WAY, SAN BERNARDINO, CA 92415(909) 388-0810(909) 890-0281 Get Directions Write a Review

NPPES record last updated: September 10, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Marilyn H. Kimura M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARILYN H. KIMURA M.D. (NPI 1396876264) is an individual child & adolescent psychiatry provider in San Bernardino, California, licensed in California (G75440) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1396876264

Entity TypeIndividualFemale

Primary Taxonomy2084P0804X

Provider Legal NameMARILYN H. KIMURACredential: M.D.

Location Address303 E VANDERBILT WAYSan Bernardino, CA 92415-0026

Mailing Address217 Cedar St # 237Sandpoint, ID 83864-1410 · (208) 904-2702 · Fax (208) 904-2703

Phone(909) 388-0810

Fax(909) 890-0281

Sole ProprietorYes

Enumeration DateMarch 9, 2007

Last NPPES UpdateSeptember 10, 2021

NPPES CertifiedSeptember 10, 2021

✔ NPI 1396876264 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0804X

License✔ Licensed in CA · G75440

Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License M11081 (ID)

303 E VANDERBILT WAY, San Bernardino, CA 92415

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marilyn H. Kimura M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Marilyn Kimura reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

County Of San Bernardino

Same address

Mental Health (Including Community Mental Health Center)

303 E VANDERBILT WAY
San Bernardino, CA 92415

Reassigned Medicare billing, California enrollment
233 clinicians in this Medicare group

NPI 1164467023 (909) 388-0801

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANTOINETTE AZAR M.D.

Psychiatry & Neurology (Child & Adolescent Psychiatry)