=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558288241
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | IT MUST BE KISMET MEDICAL AND AESTHETICS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/02/2026
-----------------------------------------------------
Last Update Date | 07/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3877 SHAWN WAY STE 168
-----------------------------------------------------
City | LOOMIS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95650-9287
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-250-1010
-----------------------------------------------------
Fax | 800-905-5787
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3877 SHAWN WAY STE 168
-----------------------------------------------------
City | LOOMIS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95650-9287
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-250-1010
-----------------------------------------------------
Fax | 800-905-5787
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | DR. KISMET THOMPSON ROBERTS
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 916-250-1010
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------