Jack Ji, PHD, FACMG

Primary specialty

Clinical Laboratory Director (Non-physician)Taxonomy code 247ZC0005X

License

JIXXJ1 Issued in NY

Practice address

180 Kimball Way
South San Francisco, CA 94080-6218

Phone

(888) 268-6795

Fax

(608) 541-2450

NPI assigned

Jun 4, 2019

Last updated

Jun 4, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Myriad Women's Health, Inc.

  • Clinical Medical Laboratory
  • South San Francisco, CA
  • NPI 1346479169
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1205494218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 KIMBALL WAY",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940806218",
            "telephone_number": "888-268-6795",
            "fax_number": "608-541-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 KIMBALL WAY",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940806218",
            "telephone_number": "888-268-6795",
            "fax_number": "608-541-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JI",
        "first_name": "JACK",
        "credential": "PHD, FACMG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-04",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247ZC0005X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": "NY",
            "license": "JIXXJ1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Lynn Jasper, NURSE PRACTITIONER
• Nikoo Javanmardi, D.C.
• Jack Yungzen Jeng, MD
• Rachel Jerome
• Jalen Jewett
• Bin Jiang, MD, PHD
• Calvin Jiang, PHARM.D.
• Cida A Jimenez, PHD
• Oscar Jimenez, RD
• Susan Dean Johns, PT

• Clinical Laboratory Director (Non-physician) in South San Francisco, CA
• Providers in South San Francisco, CA by specialty
• Clinical Laboratory Director (Non-physician) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.