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General NPI Number Information
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NPI Number | 1376429076
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Entity Type | Organization
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Legal Business Name | KOHIF PHARMAGENIX LLC
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Dates
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Enumeration Date | 08/15/2025
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 3533 CANYON DE FLORES STE A
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City | SIERRA VISTA
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State | AZ
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Zip | 85650-5366
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Country | US
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Telephone | 254-292-0182
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Fax |
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Provider Business Mailing Address
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Address Line | 3533 CANYON DE FLORES STE A
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City | SIERRA VISTA
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State | AZ
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Zip | 85650-5366
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MOSTAFA ABDELMONEM
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Credential | MSC
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Telephone | 520-736-2344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207SG0202X
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Taxonomy Name | Clinical Biochemical Genetics Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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