GENESIS COMPREHENSIVE MEDICAL GROUP NPI 1023559697

NPI Information

NPI: 1023559697
Provider Name: GENESIS COMPREHENSIVE MEDICAL GROUP
Classification: Family Medicine - 207QA0401X
Entity Type: Organization

Specialization: Addiction Medicine

CLIA Number: 05D2248812

Address:
191 S BUENA VISTA ST STE 335
BURBANK, CA
ZIP 91505
Phone: (818) 561-4733
Get Directions

GENESIS COMPREHENSIVE MEDICAL GROUP is an addiction medicine family medicine in Burbank, CA. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. GENESIS COMPREHENSIVE MEDICAL GROUP NPI is 1023559697. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

191 S BUENA VISTA ST STE 335
BURBANK, CA
ZIP 91505-562
Phone: (818) 561-4733

The provider's authorized official is Kamron Kenneth Hakhamimi .
The authorized official title is Medical Director and has the following contact phone number (323) 697-2330.

The CLIA number assigned to this NPI record is 05D2248812 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/16/2017 and was last updated on 10/14/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QA0401X	Family Medicine	Addiction Medicine	A74169	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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