MEDICARE: DR. GENY AUGUSTINE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	63631	AZ
2	207Q00000X	Family Medicine Physician	MT216298	PA

General Provider Information

NPI Number	:	1083108401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GENY AUGUSTINE MD

Provider Business Mailing Address
First Line	:	7701 W ASPERA BLVD
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-7947
Country	:	US
Telephone Number	:	623-465-6060
Fax Number	:

Provider Business Practice Location Address
First Line	:	401 WARREN ST STE 300
Second Line	:
City	:	REDWOOD CITY
State	:	CA
Zip	:	94063-1536
Country	:	US
Telephone Number	:	240-693-3281
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2018
Last Update Date	:	03/17/2026

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Directions to “ DR. GENY AUGUSTINE MD” Practice Location

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