Provider Demographics
NPI:1245590447
Name:KAGIHARA, JAMIE (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:
Last Name:KAGIHARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S ALAMEDA ST UNIT 130
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-3929
Mailing Address - Country:US
Mailing Address - Phone:808-230-0397
Mailing Address - Fax:
Practice Address - Street 1:2841 LOMITA BLVD STE 235
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5111
Practice Address - Country:US
Practice Address - Phone:310-517-8951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA135922207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA135922Medicaid