Healthcare Provider Details

I. General information

NPI: 1326610148
Provider Name (Legal Business Name): JIAKAI JI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2021
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11602 HAWTHORNE BLVD STE A
HAWTHORNE CA
90250-2316
US

IV. Provider business mailing address

11602 HAWTHORNE BLVD STE A
HAWTHORNE CA
90250-2316
US

V. Phone/Fax

Practice location:
  • Phone: 310-694-5255
  • Fax: 310-306-5555
Mailing address:
  • Phone: 310-694-5255
  • Fax: 310-306-5555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA202018
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: