Provider Demographics
NPI:1770336059
Name:KARNESIS, GEORGIOS KIMON
Entity type:Individual
Prefix:
First Name:GEORGIOS KIMON
Middle Name:
Last Name:KARNESIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 GRIGORIOU LAMPRAKI
Mailing Address - Street 2:
Mailing Address - City:CHALANDRI
Mailing Address - State:ATTICA
Mailing Address - Zip Code:15238
Mailing Address - Country:GR
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2101 N WATERMAN AVE
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-4836
Practice Address - Country:US
Practice Address - Phone:909-883-8711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program