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General NPI Number Information
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NPI Number | 1245972892
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Entity Type | Organization
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Legal Business Name | GENEVA MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 04/12/2022
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Last Update Date | 04/12/2022
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Provider Practice Location Address
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Address Line | 3160 GENEVA ST
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City | LOS ANGELES
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State | CA
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Zip | 90020-1117
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Country | US
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Telephone | 213-388-6168
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Fax | 213-388-7168
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Provider Business Mailing Address
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Address Line | 3700 WILSHIRE BLVD STE 200
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City | LOS ANGELES
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State | CA
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Zip | 90010-2903
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Country | US
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Telephone | 213-388-6168
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Fax | 213-388-7168
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Authorized Official
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Title or Position | CEO
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Name | DR. KYUNG CHO
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Credential |
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Telephone | 213-388-6168
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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