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Organization
KINGSTON HEALTH GROUP
Active
Organization
KINGSTON HEALTH GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JACOB GHODS (PRESIDENT)
(424) 258-0124
Entity
Organization
Contact information
Practice address
955 CARRILLO DR STE 900, LOS ANGELES, CA 90048-5472
(424) 502-0336
Mailing address
955 CARRILLO DR STE 900, LOS ANGELES, CA 90048-5472
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
2084P0800X
Psychiatry Physician
—
—
225100000X
Physical Therapist
Primary
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Enumeration date
10/01/2024
Last updated
07/14/2026
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