Genesis Medspa, Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A-26431 Issued in CA

Legal business name

GENESIS MEDSPA, INC

Practice address

22323 Sherman Way
Suite # 19-20
Canoga Park, CA 91303-1002

Phone

(818) 884-8110

Fax

(805) 832-4301

NPI assigned

Apr 4, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Margarita Lozada Fernandez, NURSE PRACTITIONER

Title

Secretary

Phone

(858) 254-3762

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Maria J Lozada, D.M.D.

  • General Practice Dentistry
  • Canoga Park, CA
  • NPI 1801905989
  NPD (past)

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

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365033600000",
    "number": "1992048250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 BAYSIDE CIR",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930352147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22323 SHERMAN WAY",
            "address_2": "SUITE # 19-20",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913031002",
            "telephone_number": "818-884-8110",
            "fax_number": "805-832-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS MEDSPA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-04",
        "last_updated": "2013-04-04",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "MARGARITA",
        "authorized_official_middle_name": "LOZADA",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "858-254-3762",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A-26431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Selom Gbewonyo
• Karen Ruth Gean, R.N.
• James Gearing
• Hannah Geelan
• Stephanie Geismar
• Briana George
• Elias Gerhardt
• Hermineh Gharbi
• GHC of Canoga Park, LLC
• Jason Gillard, MSW

• Internal Medicine Physician in Canoga Park, CA
• Providers in Canoga Park, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; 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.