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General NPI Number Information
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NPI Number | 1710838917
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Entity Type | Organization
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Legal Business Name | GENESIS MANAGEMENT INNOVATION CORP
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Dates
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Enumeration Date | 02/04/2026
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 245 MAIN ST # C12
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City | VENICE
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State | CA
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Zip | 90291-2590
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Country | US
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Telephone | 310-399-5566
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Fax |
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Provider Business Mailing Address
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Address Line | 325 S CHAPEL AVE APT A
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City | ALHAMBRA
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State | CA
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Zip | 91801-4296
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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 | PRESIDENT
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Name | GEN LI
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Credential |
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Telephone | 858-603-2933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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