GENESIS FUNCTIONAL RESTORATION CLINIC INC NPI 1912443490

NPI Information

GENESIS FUNCTIONAL RESTORATION CLINIC INC 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 FUNCTIONAL RESTORATION CLINIC INC NPI is 1912443490. 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
335
BURBANK, CA
ZIP 91505-554
Phone: (323) 697-2330

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 enumeration date for this NPI number is 1/9/2017 and was last updated on 1/9/2017.

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:

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