Healthcare Provider Details

I. General information

NPI: 1790715860
Provider Name (Legal Business Name): SEN JI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 12/02/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4867 W SUNSET BLVD 6 TH FLOOR
LOS ANGELES CA
90027-5969
US

IV. Provider business mailing address

4867 W SUNSET BLVD 6 TH FLOOR
LOS ANGELES CA
90027-5969
US

V. Phone/Fax

Practice location:
  • Phone: 323-783-5850
  • Fax: 323-783-8974
Mailing address:
  • Phone: 323-783-5850
  • Fax: 323-783-8974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA72488
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberA72488
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: