Genesis Advanced Services III, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

GENESIS ADVANCED SERVICES III, LLC

Practice address

16130 Kokanee Rd Ste 101
Apple Valley, CA 92307-0833

Phone

(805) 416-1648

NPI assigned

Dec 23, 2014

Organization subpart

No

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

Authorized official

Name

Cort Colbert

Title

Manager

Phone

(805) 416-1648

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1419292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419292800000",
    "number": "1639567787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16130 KOKANEE RD STE 101",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923070833",
            "telephone_number": "805-416-1648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16130 KOKANEE RD STE 101",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923070833",
            "telephone_number": "805-416-1648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS ADVANCED SERVICES III, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-23",
        "last_updated": "2014-12-23",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "CORT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "805-416-1648"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Doe Denise Gasque, FNP-C
• Krystell Noeli Gastelum, L/COTA
• Gerardo Nicolas Gaytan
• Mike Heshmat Gebrael
• Gerard Gemelga, CRNA
• Genesis OBGYN Medical Group Inc.
• Denise Marie George
• Kimberly George, CNM
• Gerald Radlauer MD Inc
• Lynley Giagnocavo, LMFT

• Clinical Medical Laboratory in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.