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General NPI Number Information
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NPI Number | 1184565863
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Entity Type | Organization
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Legal Business Name | JI SON MD CORP
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Dates
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Enumeration Date | 04/04/2026
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Last Update Date | 04/04/2026
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Provider Practice Location Address
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Address Line | 5505 E SANTA ANA CANYON RD UNIT 17852
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City | ANAHEIM
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State | CA
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Zip | 92817-1241
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Country | US
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Telephone | 951-268-7009
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Fax |
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Provider Business Mailing Address
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Address Line | 5505 E SANTA ANA CANYON RD UNIT 17852
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City | ANAHEIM
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State | CA
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Zip | 92817-1241
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. JI SON
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Credential | MD
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Telephone | 949-394-2784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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