Organization Active NPI

Geoffey L Kamen MD a Professional Corporation

  • Family Medicine Physician
  • San Luis Obispo, CA
National Provider Identifier
1073311460
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GEOFFEY L KAMEN MD A PROFESSIONAL CORPORATION
Practice address
1150 Grove St # B
San Luis Obispo, CA 93401-2914
Phone
(805) 596-1565
Fax
(833) 428-4062
NPI assigned
Mar 3, 2025
Last updated
Jun 20, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
GEFFREY L KAMEN MD A PROFESSIONAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Authorized official

Name
Dr. Geoffrey L Kamen, MDNPI 1215015953
Title
Director
Phone
(805) 596-1565

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1150 Grove St # B
San Luis Obispo, CA 93401-2914

Mailing address

793 E Foothill Blvd Ste A117
San Luis Obispo, CA 93405-1615
Phone (805) 550-8880

Other practice location 1

11355 Los Osos Valley Rd Apt C
San Luis Obispo, CA 93405-6368
Phone (805) 550-8880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250815002730 CA Part B Supplier - Clinic/Group Practice 5294234373 Receives reassigned benefits from 1 practitioner
Practice locations: San Luis Obispo, CA

National Provider Directory

National Provider Directory
Part of
Geoffey L Kamen MD a Professional Corporation

Locations

6907 El Camino Real
Ste A
Atascadero, CA 93422
Phone (805) 550-8880

1150 Grove St
#B
San Luis Obispo, CA 93401
Phone (805) 596-1565

1150 Grove St
Ste B
San Luis Obispo, CA 93401
Phone (805) 596-1565

187 Tank Farm Rd
#230B
San Luis Obispo, CA 93401
Phone (805) 596-1565

793 E Foothill Blvd
#A117
San Luis Obispo, CA 93405

793 E Foothill Blvd
Ste A117
San Luis Obispo, CA 93405

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1740960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750377600000",
    "number": "1073311460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "793 E FOOTHILL BLVD STE A117",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051615",
            "telephone_number": "805-550-8880",
            "fax_number": "833-428-4062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 GROVE ST # B",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012914",
            "telephone_number": "805-596-1565",
            "fax_number": "833-428-4062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11355 Los Osos Valley Rd Apt C",
            "address_purpose": "LOCATION",
            "city": "San Luis Obispo",
            "state": "CA",
            "postal_code": "934056368",
            "country_code": "US",
            "telephone_number": "805-550-8880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GEOFFEY L KAMEN MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEFFREY L KAMEN MD A PROFESSIONAL CORPORATION",
        "enumeration_date": "2025-03-03",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A",
        "authorized_official_last_name": "KAMEN",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "805-596-1565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2025; 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.