Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kimberly Marie Reno, PA-C

Individual provider Physician Assistant · NPI 1679902803

Kimberly Marie Reno, PA-C is a Physician Assistant in San Diego, California. Qualified in 2013, 13 years ago. Practices with Henry Ford Macomb Hospital Corporation, a 339-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California, Georgia and Michigan.

Years since qualifying
13
Licensed in
CA, GA, MI
In the registry since
2013
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4060 4th Ave #700
San Diego, CA 92103
Phone: (619) 299-8500
Fax: (619) 299-3370
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 105 E 9th St, Coralville, IA 52241-2209 — (319) 467-2000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601008333 (MI)
Physician Assistant Taxonomy 363A00000X · Licence 007055 (GA)
Physician Assistant Taxonomy 363A00000X · Licence PA60679 (CA)

Record details

NPI number1679902803
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 7, 2013
Last updated in NPPESFebruary 2, 2026
Certification dateFebruary 2, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Henry Ford Macomb Hospital Corporation — 339 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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