Genesis Comprehensive Medical Group

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

A74169 Issued in CA

Legal business name

GENESIS COMPREHENSIVE MEDICAL GROUP

Practice address

191 S Buena Vista St Ste 335
Burbank, CA 91505-4562

Phone

(818) 561-4733

NPI assigned

Mar 16, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kamron Kenneth Hakhamimi, M.D.NPI 1366742629

Title

Medical Director

Phone

(323) 697-2330

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kamron Kenneth Hakhamimi, M.D.

  • Addiction Medicine (Family Medicine) Physician
  • Burbank, CA
  • NPI 1366742629
  Medicare reassignment NPD Authorized official
• Houshang Hakhamimi, M.D.

  • Surgery Physician
  • Beverly Hills, CA
  • NPI 1033271515
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1489622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602633600000",
    "number": "1023559697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 S BUENA VISTA ST STE 335",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054562",
            "telephone_number": "818-561-4733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 S BUENA VISTA ST STE 335",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054562",
            "telephone_number": "818-561-4733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS COMPREHENSIVE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-16",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A",
        "authorized_official_last_name": "HAKHAMIMI",
        "authorized_official_first_name": "KAMRON",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "323-697-2330",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "CA",
            "license": "A74169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jocelyn Gee, MA, AMFT
• Matt S. Gee, PH.D.
• John Guido Geirland, PH.D.
• Shirley Cecile Geller, PH.D.
• Generation Care la
• Genesis Functional Restoration Clinic Inc
• Genesis Health Group
• Genesis Occupational Medical Clinic Inc
• Genex Laboratory Services,Inc
• Gentle Healing/Care, Inc.

• Addiction Medicine (Family Medicine) Physician in Burbank, CA
• Providers in Burbank, CA by specialty
• Addiction Medicine (Family Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.