Healthcare Provider Details

I. General information

NPI: 1598293391
Provider Name (Legal Business Name): KHYRIE JONES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2017
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3711 LONG BEACH BLVD STE 4105
LONG BEACH CA
90807-3315
US

IV. Provider business mailing address

3711 LONG BEACH BLVD STE 4105
LONG BEACH CA
90807-3315
US

V. Phone/Fax

Practice location:
  • Phone: 562-414-4452
  • Fax: 562-381-8130
Mailing address:
  • Phone: 562-414-4452
  • Fax: 562-381-8130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberA173097
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: