Healthcare Provider Details

I. General information

NPI: 1336152099
Provider Name (Legal Business Name): MOHSEN N/A JAMEI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: N/A N/A N/A M.D.

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 03/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15301 S SAN JOSE AVE
COMPTON CA
90221-3131
US

IV. Provider business mailing address

808 W 58TH ST
LOS ANGELES CA
90037-3632
US

V. Phone/Fax

Practice location:
  • Phone: 562-630-6825
  • Fax: 562-634-5382
Mailing address:
  • Phone: 323-541-1616
  • Fax: 323-541-1401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA84432
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: