MEDICARE: JIAKAI JI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	A202018	CA

General Provider Information

NPI Number	:	1326610148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIAKAI JI MD

Provider Business Mailing Address
First Line	:	11602 HAWTHORNE BLVD STE A
Second Line	:
City	:	HAWTHORNE
State	:	CA
Zip	:	90250-2316
Country	:	US
Telephone Number	:	310-694-5255
Fax Number	:	310-306-5555

Provider Business Practice Location Address
First Line	:	11602 HAWTHORNE BLVD STE A
Second Line	:
City	:	HAWTHORNE
State	:	CA
Zip	:	90250-2316
Country	:	US
Telephone Number	:	310-694-5255
Fax Number	:	310-306-5555

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2021
Last Update Date	:	04/10/2026

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