KUSH MEDICAL GROUP
NPI 1104958784
Anesthesiology - Pain Medicine in Gardena, CA
NPI Status: Active since March 10, 2007
Contact Information
14015 VAN NESS AVE # 10
GARDENA, CA
ZIP 90249
Phone: (310) 327-7682
Fax: (310) 327-7765
- Organization
- Anesthesiology
- Pain Medicine
About KUSH MEDICAL GROUP
This page provides the complete NPI Profile along with additional information for Kush Medical Group, a provider established in Gardena, California operating as a Anesthesiology, focusing in pain medicine . The healthcare provider is registered in the NPI registry with number 1104958784 assigned on March 2007. The practitioner's primary taxonomy code is 207LP2900X with license number A45536 (CA). The provider is registered as an organization and their NPI record was last updated one year ago. Kush Medical Group operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Dr. Kiansi Boni Md (Owner)
- NPI
- 1104958784
- Provider Name
- KUSH MEDICAL GROUP
- Entity Type
- Organization
- Location Address
- 14015 VAN NESS AVE # 10 GARDENA, CA 90249
- Location Phone
- (310) 327-7682
- Location Fax
- (310) 327-7765
- Mailing Address
- PO BOX 6299 TORRANCE, CA 90504
- Mailing Phone
- (310) 327-7682
- Mailing Fax
- (310) 327-7765
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-10-2007
- Last Update Date
- 09-11-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Anesthesiology Pain Medicine
- Taxonomy Code
- 207LP2900X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- A45536
- License State
- CA
- Taxonomy Description
- An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | A45536 (CA) |
| 2 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | A45536 (CA) |
| 3 | 208VP0014X | Allopathic & Osteopathic Physicians | Pain Medicine | A45536 (CA) |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 00A455361 | MEDICAID (05) | CA |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1104958784, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 66 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104958784, enumerated as an "organization" on March 10, 2007.
The provider is located at 14015 VAN NESS AVE # 10 GARDENA, CA 90249 and the phone number is (310) 327-7682.
Anesthesiology with taxonomy code 207LP2900X and a focus in Pain Medicine.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
