Individual ProviderJingran JiInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address2020 Santa Monica Blvd Ste 200, Santa Monica, CA 90404-2023(310) 829-5471(310) 301-8707PECOS EnrollmentBased on the most recent information from CMS, provider Jingran Ji is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1114319423Provider TypeIndividualFull NameJi, JingranGenderMaleSole ProprietorYesEnumeration Date2/23/2015Last Updated8/1/2024Contact InformationPractice LocationPractice Address2020 Santa Monica Blvd Ste 200, Santa Monica, CA 90404-2023Phone(310) 829-5471FaxUnlisted FaxMailing LocationMailing Address5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631Phone(310) 301-8707FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseA163688CaliforniaCode207RH0003XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseA163688CaliforniaCode207RX0202XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseA163688California