Provider Demographics
NPI:1740443761
Name:JASON KANJI MD INC
Entity type:Organization
Organization Name:JASON KANJI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:KANJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-217-4719
Mailing Address - Street 1:3171 LOS FELIZ BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-1536
Mailing Address - Country:US
Mailing Address - Phone:323-644-0446
Mailing Address - Fax:
Practice Address - Street 1:3171 LOS FELIZ BLVD STE 200
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039-1536
Practice Address - Country:US
Practice Address - Phone:323-644-0446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA892922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty