Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081P2900X | Pain Medicine | 153109 | CA |
NPI | 1134480510 |
---|---|
Provider Name | Dr. Kevin Jiang |
First Address | Simi Valley, CA 93065-1218 |
Second Address | Simi Valley, CA 93065-1218 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2012 |
Last Update Date | 16/10/2020 |