Provider Demographics
NPI:1407389695
Name:GENOME MEDICAL SERVICES
Entity Type:Organization
Organization Name:GENOME MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLEYL
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:877-688-0992
Mailing Address - Street 1:701 GATEWAY BLVD STE 380
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-7420
Mailing Address - Country:US
Mailing Address - Phone:877-688-0992
Mailing Address - Fax:856-961-5322
Practice Address - Street 1:701 GATEWAY BLVD STE 380
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-7420
Practice Address - Country:US
Practice Address - Phone:877-688-0992
Practice Address - Fax:856-961-5322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-05
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes170300000XOther Service ProvidersGenetic Counselor, MSGroup - Single Specialty