Ketamine Infusion Associates, Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

KETAMINE INFUSION ASSOCIATES, INC.

Practice address

2975 Treat Boulevard
Suite Number B-1
Concord, CA 94518

Phone

(925) 357-9033

Fax

(925) 357-9036

NPI assigned

Dec 17, 2020

Organization subpart

No

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

Authorized official

Name

Ran Kim, M.D.

Title

President

Phone

(925) 357-9033

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608163200000",
    "number": "1841886488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2975 TREAT BOULEVARD",
            "address_2": "SUITE NUMBER B-1",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "94518",
            "telephone_number": "925-357-9033",
            "fax_number": "925-357-9036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2975 TREAT BOULEVARD",
            "address_2": "SUITE NUMBER B-1",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "94518",
            "telephone_number": "925-357-9033",
            "fax_number": "925-357-9036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETAMINE INFUSION ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-17",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "RAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-357-9033",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iryna Kermach
• Kristopher Curtis Kern
• Melissa Kersten, MFT
• Cheshmeh Keshmiri
• Jessica Keslinke
• Ilunga Kazadi Kevyne
• Mohlatso Jacqueline Kgatla
• Anjelika Khadka
• Samia Khalid
• Maryan Iman Khalif

• Clinic/Center in Concord, CA
• Providers in Concord, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.