Provider Demographics
NPI:1801395751
Name:KIND HEALTH GROUP
Entity Type:Organization
Organization Name:KIND HEALTH GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGINE
Authorized Official - Middle Name:
Authorized Official - Last Name:NANOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-701-5463
Mailing Address - Street 1:351 SANTA FE DR STE 220
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-5137
Mailing Address - Country:US
Mailing Address - Phone:760-701-5463
Mailing Address - Fax:
Practice Address - Street 1:351 SANTA FE DR STE 220
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5137
Practice Address - Country:US
Practice Address - Phone:760-701-5463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-06
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85136207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty