Organization
ACTINIUM MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKSON CHEUK KI MA MD (PRESIDENT)
(323) 528-1565
Entity
Organization
Contact information
Practice address
120 W BEVERLY BLVD, MONTEBELLO, CA 90640-4305
(323) 528-1565
Mailing address
120 W BEVERLY BLVD, MONTEBELLO, CA 90640-4305
(323) 490-7231
(323) 490-7282
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
10/28/2022
Last updated
03/30/2026
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