Active NPI
Jacob Klickstein
- Neurology Physician
- Los Angeles, CA
National Provider Identifier
1508639774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 20018
- Practice address
- 300 UCLA Medical PLZ BLDG 200
Los Angeles, CA 90095-8346 - Phone
- (310) 794-1195
- Fax
- (504) 387-8979
- NPI assigned
- Oct 31, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 20018 | CA | Primary |
Addresses
Primary practice location
300 UCLA Medical PLZ BLDG 200
Los Angeles, CA 90095-8346
Mailing address
300 UCLA Medical PLZ # B200
Los Angeles, CA 90095-8346
Phone (310) 794-1195
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20018 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770336000000",
"number": "1508639774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 UCLA MEDICAL PLZ # B200",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900958346",
"telephone_number": "310-794-1195",
"fax_number": "504-387-8979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 UCLA MEDICAL PLZ BLDG 200",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900958346",
"telephone_number": "310-794-1195",
"fax_number": "504-387-8979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLICKSTEIN",
"first_name": "JACOB",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-10-31",
"last_updated": "2026-02-06",
"certification_date": "2026-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "CA",
"license": "20018",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.