Healthcare Provider Details
I. General information
NPI: 1689584674
Provider Name (Legal Business Name): GENESIS HEALTHCARE PARTNERS PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2999 REGENT ST STE 612
BERKELEY CA
94705-2121
US
IV. Provider business mailing address
21250 HAWTHORNE BLVD STE 600
TORRANCE CA
90503-5519
US
V. Phone/Fax
- Phone: 510-848-1727
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332900000X |
| Taxonomy | Non-Pharmacy Dispensing Site |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EDWARD
STEVEN
COHEN
Title or Position: PRESIDENT
Credential:
Phone: 858-888-7700