Provider Demographics
NPI:1437536505
Name:KAS MEDICAL GROUP INC
Entity Type:Organization
Organization Name:KAS MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KARIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-393-1870
Mailing Address - Street 1:12826 VICTORY BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3013
Mailing Address - Country:US
Mailing Address - Phone:818-583-0055
Mailing Address - Fax:
Practice Address - Street 1:12826 VICTORY BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3013
Practice Address - Country:US
Practice Address - Phone:818-583-0055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-28
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC51512208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty