Active NPI
Jaleel Azim Gilmore
- Massage Therapist
- Gardena, CA
National Provider Identifier
1871619437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 56751
- Practice address
- 879 W 190TH St Ste 400-56
Gardena, CA 90248-4220 - Phone
- (323) 702-6890
- NPI assigned
- Mar 22, 2007
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 56751 | CA | Primary |
Addresses
Primary practice location
879 W 190TH St Ste 400-56
Gardena, CA 90248-4220
Mailing address
879 W 190TH St Ste 400-56
Gardena, CA 90248-4220
Phone (323) 702-6890
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 |
|---|---|---|---|
| 56751 | CA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Health & Rehabilitation Program | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Lynwood, CA
- NPI 1467775221
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749513600000",
"number": "1871619437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "879 W 190TH ST STE 400-56",
"city": "GARDENA",
"state": "CA",
"postal_code": "902484220",
"telephone_number": "323-702-6890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "879 W 190TH ST STE 400-56",
"city": "GARDENA",
"state": "CA",
"postal_code": "902484220",
"telephone_number": "323-702-6890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILMORE",
"first_name": "JALEEL",
"middle_name": "AZIM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-22",
"last_updated": "2025-06-10",
"certification_date": "2025-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "56751",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gardena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.