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General NPI Number Information
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NPI Number | 1215015953
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Entity Type | Individual
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Provider Name | GEOFFREY L KAMEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 07/06/2025
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Provider Practice Location Address
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Address Line | 1150 GROVE ST # B
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-2914
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Country | US
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Telephone | 805-596-1565
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Fax | 833-428-4062
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Provider Business Mailing Address
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Address Line | 793 E FOOTHILL BLVD # A117
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93405-1615
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Country | US
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Telephone | 55-961-5658
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Fax | 833-428-4062
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 13673
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 207QA0000X
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Taxonomy Name | Adolescent Medicine (Family Medicine) Physician
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License Number | 240096
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A115526
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License Number State | CA
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