Individual
JERRY ELIJAH MCCLELLAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2501 W EL SEGUNDO BLVD, HAWTHORNE, CA 90250-3317
(323) 754-2816
Mailing address
2501 W EL SEGUNDO BLVD, HAWTHORNE, CA 90250-3317
(323) 754-2816
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-JIFPUM
CA
Other
Enumeration date
06/23/2026
Last updated
06/23/2026
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