Provider Demographics
NPI:1790715860
Name:JI, SEN (MD)
Entity Type:Individual
Prefix:
First Name:SEN
Middle Name:
Last Name:JI
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4867 W SUNSET BLVD
Mailing Address - Street 2:6 TH FLOOR
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-5969
Mailing Address - Country:US
Mailing Address - Phone:323-783-5850
Mailing Address - Fax:323-783-8974
Practice Address - Street 1:4867 W SUNSET BLVD
Practice Address - Street 2:6 TH FLOOR
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5969
Practice Address - Country:US
Practice Address - Phone:323-783-5850
Practice Address - Fax:323-783-8974
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2021-12-02
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Provider Licenses
StateLicense IDTaxonomies
CAA72488207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1013756220001Medicaid
PA1013756220001Medicaid
I42663Medicare UPIN