Provider Demographics
NPI:1487120820
Name:COMPREHENSIVE PRIMARY CARE, LLC
Entity type:Organization
Organization Name:COMPREHENSIVE PRIMARY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REKHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KESAVAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-296-5504
Mailing Address - Street 1:3905 JOHNS CREEK COURT SUITE 200
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024
Mailing Address - Country:US
Mailing Address - Phone:678-888-2273
Mailing Address - Fax:678-888-2200
Practice Address - Street 1:761 WALTHER ROAD SUITE 200
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046
Practice Address - Country:US
Practice Address - Phone:678-888-2273
Practice Address - Fax:678-888-2200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-23
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty