Healthcare Provider Details

I. General information

NPI: 1861009011
Provider Name (Legal Business Name): RAIMY JAMAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2020
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12432 BELLFLOWER BLVD
DOWNEY CA
90242-2806
US

IV. Provider business mailing address

4335 ATLANTIC AVE
LONG BEACH CA
90807-2803
US

V. Phone/Fax

Practice location:
  • Phone: 818-241-6780
  • Fax:
Mailing address:
  • Phone: 562-216-4900
  • Fax: 562-484-3039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: