Jane Kakkis, MD, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

A53546 Issued in CA

Legal business name

JANE KAKKIS, MD, INC.

Practice address

9900 Talbert Ave
Suite 103
Fountain Valley, CA 92708-5153

Phone

(714) 378-5011

Fax

(714) 378-5051

NPI assigned

Oct 14, 2008

Organization subpart

No

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

Authorized official

Name

Jane Lilian Kakkis, MD, MPHNPI 1598715427

Title

Surgeon

Phone

(714) 378-5011

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jane L. Kakkis, M.D.

  • Specialist
  • Fountain Valley, CA
  • NPI 1598715427
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1223942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223942400000",
    "number": "1902058670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 TALBERT AVE",
            "address_2": "SUITE 103",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085153",
            "telephone_number": "714-378-5011",
            "fax_number": "714-378-5051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 TALBERT AVE",
            "address_2": "SUITE 103",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085153",
            "telephone_number": "714-378-5011",
            "fax_number": "714-378-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JANE KAKKIS, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-14",
        "last_updated": "2008-10-14",
        "status": "A",
        "authorized_official_last_name": "KAKKIS",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "LILIAN",
        "authorized_official_title_or_position": "SURGEON",
        "authorized_official_telephone_number": "714-378-5011",
        "authorized_official_credential": "MD, MPH"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A53546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.