# KUSH MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104958784
- **Authorized official:** DR. KIANSI BONI MD (OWNER)
- **Authorized official phone:** (310) 644-3488

## Contact information

- **Practice address:** 14015 VAN NESS AVE \# 10, GARDENA, CA 90249-2937
- **Practice address phone:** (310) 327-7682
- **Practice address fax:** (310) 327-7765
- **Mailing address:** PO BOX 6299, TORRANCE, CA 90504-0299
- **Mailing address phone:** (310) 327-7682
- **Mailing address fax:** (310) 327-7765

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | A45536 | CA | Yes |
| 207Q00000X | Family Medicine Physician | A45536 | CA | — |
| 208000000X | Pediatrics Physician | A45536 | CA | — |
| 208VP0014X | Interventional Pain Medicine Physician | A45536 | CA | — |

## Other

- **Enumeration date:** 03/10/2007
- **Last updated:** 09/11/2025