# GENESIS FAMILY CARE MEDICAL GROUP, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pacific Coast Family Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467640409
- **Authorized official:** DR. RONALD RUBY J. (PRESIDENT)
- **Authorized official phone:** (310) 545-6627

## Contact information

- **Practice address:** 1101 N SEPULVEDA BLVD STE 102, MANHATTAN BEACH, CA 90266-5962
- **Practice address phone:** (310) 545-6627
- **Practice address fax:** (310) 545-0352
- **Mailing address:** 1101 N SEPULVEDA BLVD STE 102, MANHATTAN BEACH, CA 90266-5962
- **Mailing address phone:** (310) 545-6627
- **Mailing address fax:** (310) 545-0352

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | G34101 | CA | Yes |

## Other

- **Enumeration date:** 10/03/2007
- **Last updated:** 05/29/2015