KUSH MEDICAL GROUP (NPI# 1104958784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104958784 |
| Entity Type | Organization |
| Organization Name | KUSH MEDICAL GROUP |
| Practice Address |
14015 Van Ness Ave # 10 Gardena CA 90249-2937 |
| Mailing Address |
Po Box 6299 Torrance CA 90504-0299 |
| Practice Telephone | 3103277682 |
| Practice Fax Number | 3103277765 |
| Mailing Telephone | 3103277682 |
| Mailing Fax Number | 3103277765 |
| Enumeration Date | 2007-03-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. KIANSI BONI (OWNER) |
| Authorized Official Telephone | 3106443488 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
A45536 | CA | Allopathic & Osteopathic Physicians |
| X | 207Q00000X | Family Medicine | A45536 | CA | Allopathic & Osteopathic Physicians |
| X | 208000000X | Pediatrics | A45536 | CA | Allopathic & Osteopathic Physicians |
| X | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
A45536 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A455361 | 05 |
| Street Address |
14015 VAN NESS AVE # 10 |
| City | GARDENA |
| State | CA |
| Zip Code | 90249-2937 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821518085 | Jin Taek Limb | Chiropractor | 2911 W 135th Pl, Gardena, CA 90249 | 2017-06-20 |
| 1083084651 | Charde Antoinette | Home Health | 2923 W 138th, Gardena, CA 90249 | 2015-09-25 |
| 1316330145 | Lupita Martinez | Marriage & Family Therapist | 15120 Atkinson Ave Ste 7, Gardena, CA 90249 | 2015-03-18 |
| 1699100487 | Asian American Drug Abuse Program, Inc | Community/Behavioral Health | 14112 S. Kingsley Dr., Gardena, CA 90249 | 2013-09-11 |
| 1992142327 | Vin'ash Coaching, LLC | Private Vehicle | 3163 W 154th Place, Gardena, CA 90249 | 2013-05-24 |
| 1811287048 | Best-option Home Health Agency Inc. | Home Health | 15223 S Crenshaw Blvd Suite A, Gardena, CA 90249 | 2011-04-08 |
| 1356644439 | Ameripride Ambulance Service, Inc. | Ambulance | 13509 South Raymond Avenue, Gardena, CA 90249 | 2010-12-13 |
| 1164732327 | Ctc Healthcare Services Inc | In Home Supportive Care | 13108 Arcturus Avenue, Gardena, CA 90249 | 2010-10-20 |
| 1407170996 | Marl Soon Chung | Dentist | 15622 S. Crenshaw Blvd #b, Gardena, CA 90249 | 2010-03-26 |
| 1164677464 | Grace Jiyoung Park | Family Medicine | 15446 S. Western Ave, Southern California Permanente Medical Group, Gardena, CA 90249 | 2008-12-01 |
| Find all providers in zip 90249 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346335387 | Narayan R. Roa, M.d. Inc | Anesthesiology | 1246 W 155th St, Gardena, CA 90247-4011 | 2006-10-04 |
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| 1609489418 | Cyrus Dadachanji Md Inc. | Anesthesiology | 34762 Midland Ave, Murrieta, CA 92563-8419 | 2020-08-31 |
| 1962050401 | Sky Anesthesia Inc. | Anesthesiology | 4477 W 118th St Ste 501, Hawthorne, CA 90250-2260 | 2019-08-28 |
| 1932671856 | North County Pain Institute | Anesthesiology | 940 E Valley Pkwy Ste K, Escondido, CA 92025-3441 | 2018-12-18 |
| 1285101824 | 16th Street Anesthesia Services Corp | Anesthesiology | 2323 16th St Ste 507, Bakersfield, CA 93301-3454 | 2018-11-01 |
| 1033697305 | Heyer Anesthesia PC | Anesthesiology | 1120 W La Veta Ave Ste 330, Orange, CA 92868-4231 | 2018-07-30 |
| 1982190229 | Algos Inc., A Medical Corporation | Anesthesiology | 12840 Riverside Dr Ste 208, Valley Village, CA 91607-3343 | 2018-07-10 |
| 1093200610 | Kevin Dinh Trinh, Md Inc. | Anesthesiology | 100 Fieldwood, Irvine, CA 92618 | 2018-06-26 |
| 1033616644 | Howard Siegel Md Inc | Anesthesiology | 8112 Milliken Ave Ste 202, Rancho Cucamonga, CA 91730-7473 | 2018-04-10 |
| 1780198952 | Unified Physician Associates Inc | Anesthesiology | 3200 S Bristol St Ste B, Santa Ana, CA 92704-6711 | 2017-11-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.