MEDICARE: JARED MICHAEL KIRSCH 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	208000000X	Pediatrics Physician	A190423	CA
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1528700978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JARED MICHAEL KIRSCH MD

Provider Business Mailing Address
First Line	:	225 S JUANITA AVE UNIT A
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-3693
Country	:	US
Telephone Number	:	404-610-9036
Fax Number	:

Provider Business Practice Location Address
First Line	:	14111 VAN NESS AVE STE 2
Second Line	:
City	:	GARDENA
State	:	CA
Zip	:	90249-2944
Country	:	US
Telephone Number	:	310-516-9152
Fax Number	:

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

Provider Enumeration Date	:	04/07/2022
Last Update Date	:	07/14/2025

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