Kenneth a. Geller, MD a Professional Corporation

Primary specialty

SpecialistTaxonomy code 174400000X

License

G26159 Issued in CA

Legal business name

KENNETH A. GELLER, MD A PROFESSIONAL CORPORATION

Practice address

4650 W Sunset Blvd
Chla, Division of Otolaryngology, Ms #58
Los Angeles, CA 90027-6062

Phone

(323) 669-4145

Fax

(323) 664-7327

NPI assigned

Jan 5, 2007

Organization subpart

No

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

Authorized official

Name

Kenneth Allen Geller, MD

Title

President

Phone

(323) 669-4145

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043367345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD",
            "address_2": "CHLA, DIVISION OF OTOLARYNGOLOGY, MS #58",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-669-4145",
            "fax_number": "323-664-7327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD",
            "address_2": "CHLA, DIVISION OF OTOLARYNGOLOGY, MS #58",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-669-4145",
            "fax_number": "323-664-7327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH A. GELLER, MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GELLER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-669-4145",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G26159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G261590",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Triretta Kennedy
• Yuridia Kennedy, RCP
• Emily Kennel
• Justin Leif Kennerly, PT
• Tamara Kennerly
• Kenneth C Nieberg MD Inc
• Kenneth C Nieberg MD Inc
• Kenneth C. Cooper
• Kenneth H Thomas MD Inc
• Kenneth K Kim, a Medical Corporation

• Specialist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.