Provider Demographics
NPI:1225208077
Name:GENE HORI, M.D. INCORPORATED
Entity Type:Organization
Organization Name:GENE HORI, M.D. INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GENE
Authorized Official - Middle Name:
Authorized Official - Last Name:HORI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-541-1492
Mailing Address - Street 1:4251 S HIGUERA ST
Mailing Address - Street 2:SUITE 402
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-7700
Mailing Address - Country:US
Mailing Address - Phone:805-541-1492
Mailing Address - Fax:805-541-1499
Practice Address - Street 1:4251 S HIGUERA ST
Practice Address - Street 2:SUITE 402
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-7700
Practice Address - Country:US
Practice Address - Phone:805-541-1492
Practice Address - Fax:805-541-1499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-07
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG64261208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G642610Medicaid
CA00G64261OtherBLUE SHIELD
CA340009123OtherRAILROAD MEDICARE
CAW22636Medicare PIN