Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Genesis Functional Restoration Clinic Inc

Organization Addiction Medicine (Family Medicine) Physician · NPI 1912443490

Genesis Functional Restoration Clinic Inc is an Addiction Medicine (Family Medicine) Physician in Burbank, California. Registered with an NPI since 2017.

In the registry since
2017
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

191 S Buena Vista St 335
Burbank, CA 91505-4554
Phone: (323) 697-2330
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction Medicine (Family Medicine) Physician (primary) Taxonomy 207QA0401X

Record details

NPI number1912443490
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kamron Hakhamimi — Medical Director · (323) 697-2330
NPI enumeratedJanuary 9, 2017
Last updated in NPPESJanuary 9, 2017
Mailing address191 S Buena Vista St, 335, Burbank, CA 91505-4554

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