Kush Medical Group

LBN: Kush Medical Group
Kush Medical Group is an health care organization with primary practice located at 14015 Van Ness Ave # 10 , Gardena CA 90249-2937. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is the primary health care specialty. Kush Medical Group can be contacted via phone (310) 327-7682, or through Boni, Kiansi via phone (310) 644-3488.

Contact Information

Primary practice address
14015 Van Ness Ave # 10 Gardena CA 90249-2937
Phone: (310) 327-7682
Fax: (310) 327-7765
Website:
Map and Directions
Authorized official contact:
Name: Boni, Kiansi Doctor of Medicine (MD)
Phone: (310) 644-3488

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X A45536 California
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A45536 California
Allopathic & Osteopathic Physicians / Pediatrics 208000000X A45536 California
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X A45536 California

Profile Details

NPI number 1104958784
LBN Legal business name Kush Medical Group
DBA Doing business as
Authorized official Boni, Kiansi Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 10th, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104958784 NPPES
California MEDICAID 00A455361

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