Individual provider Active NPI

Kai-Ning Jan, M.D.

  • Pediatrics Physician
  • Cudahy, CA
National Provider Identifier
1538232467
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A64542 Issued in CA
Practice address
6901 Atlantic Ave
Cudahy, CA 90201-3646
Phone
(323) 889-7828
NPI assigned
Nov 16, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A64542 CA Primary

Addresses

Primary practice location

6901 Atlantic Ave
Cudahy, CA 90201-3646

Mailing address

10769 Flaxton St
Culver City, CA 90230-5402
Phone (310) 280-8248

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220923002647 CA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 7416332671

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A64542CAMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1538232467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10769 FLAXTON ST",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902305402",
            "telephone_number": "310-280-8248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6901 ATLANTIC AVE",
            "city": "CUDAHY",
            "state": "CA",
            "postal_code": "902013646",
            "telephone_number": "323-889-7828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAN",
        "first_name": "KAI-NING",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A64542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cudahy, CA

Sources for this page

Verify at the official NPI Registry.