Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Loren Koda Kimble, PT

Individual provider Physical Therapist · NPI 1336473362

Mr. Loren Koda Kimble, PT is a Physical Therapist in Private Practice in Petaluma, California. Qualified in 2009, 17 years ago. Practices with Koda Physical Therapy and Sports Performance, a 4-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
17
Licensed in
CA
In the registry since
2009
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

1600 Corporate Cir
Petaluma, CA 94954-6912
Phone: (707) 981-8604
Fax: (707) 981-8647
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT35941 (CA)

Record details

NPI number1336473362
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorYes
NPI enumeratedSeptember 23, 2009
Last updated in NPPESMarch 9, 2017

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Koda Physical Therapy And Sports Performance — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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