K C MEDICAL GROUP INC (NPI# 1144733247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144733247 |
| Entity Type | Organization |
| Organization Name | K C MEDICAL GROUP INC |
| Practice Address |
191 S Buena Vista St Ste 375 Burbank CA 91505-4558 |
| Mailing Address |
10648 Woodbridge St Unit 302 North Hollywood CA 91602-3630 |
| Practice Telephone | 8187290014 |
| Practice Fax Number | 8187290019 |
| Mailing Telephone | 8187290014 |
| Mailing Fax Number | 8187290019 |
| Enumeration Date | 2017-11-10 |
| Last Update Date | 2017-11-10 |
| Authorized Official Name | TREASA DAVIS (PRESIDENT) |
| Authorized Official Telephone | 8187290014 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
191 S BUENA VISTA ST STE 375 |
| City | BURBANK |
| State | CA |
| Zip Code | 91505-4558 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336467620 | Treasa L Davis | Family Medicine | 191 S Buena Vista St Ste 375, Burbank, CA 91505-4558 | 2010-05-11 |
| 1750859401 | Laarni N. Domantay, Md, Inc | Family Medicine | 191 S Buena Vista St Ste 375, Burbank, CA 91505-4558 | 2018-11-09 |
| 1982171724 | Christine Depriest | Nurse Practitioner | 191 S Buena Vista St Ste 375, Burbank, CA 91505-4558 | 2018-10-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023625035 | K and S Hospice Inc | Hospice Care, Community Based | 4100 W Alameda Ave Fl 3, Burbank, CA 91505 | 2020-09-24 |
| 1013542471 | Jami Stehlin | Nurse Practitioner | 501 S. Buena Vista St. 3ne, Burbank, CA 91505 | 2020-03-06 |
| 1497309033 | Ibrahim Lala | Pharmacist | 181 S. Buena Vista St, Burbank, CA 91505 | 2019-08-01 |
| 1720501240 | Jung H Li | Registered Nurse | Psjmc- Bariatric Wellness Center, 501 S Buena Vista St, Burbank, CA 91505 | 2017-07-18 |
| 1699204974 | Beth Ellen Izbotsky | Physical Medicine & Rehabilitation | 501 S Buena Vista Blvd, Burbank, CA 91505 | 2017-06-08 |
| 1205387446 | Fabiola Bachman | Dentist | 138 N Pass Ave, 2, Burbank, CA 91505 | 2016-10-24 |
| 1114478203 | Marianna Ghularyan D.d.s. Inc | Dentist | 1400 N. Edison Blvd., Burbank, CA 91505 | 2016-10-24 |
| 1962952127 | Landa Mizin Dental Partnership | Dentist | 2625 W Alameda Ave Ste 502, Burbank, CA 91505 | 2016-10-11 |
| 1285183376 | Amy Di Francia | Marriage & Family Therapist | 4421 W Riverside Dr Ste 210, Burbank, CA 91505 | 2016-09-29 |
| 1306238381 | Abigail Merrin | Physical Therapist | 2701 W Alameda Ave Ste 206, Burbank, CA 91505 | 2015-02-26 |
| Find all providers in zip 91505 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588908776 | Cheryl Twu Do Inc | Clinic/Center | 250 N First St Unit 404, Burbank, CA 91502-1873 | 2012-11-12 |
| 1164989224 | Christopher Mcnamara M.d. Inc | Clinic/Center | 640 N Keystone St Ste B, Burbank, CA 91506-1900 | 2019-02-25 |
| 1396280707 | David Balfour Dc | Clinic/Center | 1021 N Maple St, Burbank, CA 91505-2433 | 2016-12-21 |
| 1457776866 | Pierre Manukian, M.d., Inc. | Clinic/Center | 1624 W Olive Ave, Suite F, Burbank, CA 91506-2459 | 2014-02-20 |
| 1104108802 | Arman Ossia M.d. A Professional Corporation | Clinic/Center | 2020 N Glenoaks Blvd, Burbank, CA 91504-2835 | 2011-09-19 |
| 1538322318 | Lynn J. Ramirez, Inc | Clinic/Center | 303 S Glenoaks Blvd, Suite 4, Burbank, CA 91502-1319 | 2008-07-02 |
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| 1457966442 | Carlos A. Alvarez., Md., Inc | Clinic/Center | 6001 Truxtun Ave Ste 220, Bakersfield, CA 93309-0662 | 2020-09-15 |
| 1265046395 | Riverway Medical Group A Medical Corporation | Clinic/Center | 1827 S Court St Ste B, Visalia, CA 93277-5469 | 2020-09-05 |
| 1386258754 | Apollo Health Services Inc | Clinic/Center | 438 E Katella Ave Ste 229, Orange, CA 92867-4803 | 2020-09-03 |
| 1538772843 | Unlimited Urgent Care Inc. | Clinic/Center | 8781 Van Nuys Blvd Ste A, Panorama City, CA 91402-2401 | 2020-08-26 |
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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.