Provider Demographics
NPI:1073311460
Name:GEOFFEY L KAMEN MD A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:GEOFFEY L KAMEN MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:KAMEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-596-1565
Mailing Address - Street 1:793 E FOOTHILL BLVD STE A117
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-1615
Mailing Address - Country:US
Mailing Address - Phone:805-550-8880
Mailing Address - Fax:833-428-4062
Practice Address - Street 1:6907 EL CAMINO REAL STE A
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-4386
Practice Address - Country:US
Practice Address - Phone:805-550-8880
Practice Address - Fax:833-428-4062
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GEFFREY L KAMEN MD A PROFESSIONAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty