Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Kaili Ji Shumilak, DO

Individual provider Family Medicine Physician · NPI 1831489855

MS. Kaili Ji Shumilak, DO is a Family Practice in Northridge, California. Qualified in 2011, 15 years ago. Practices with Family Health Centers of San Diego Inc, a 297-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
15
Licensed in
CA
In the registry since
2011
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

18406 Roscoe Blvd
Northridge, CA 91325-4107
Phone: (818) 993-4054
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5160 Federal Blvd, San Diego, CA 92105-5429 — (619) 515-2454

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 12796 (CA)

Record details

NPI number1831489855
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorYes
NPI enumeratedApril 11, 2011
Last updated in NPPESApril 28, 2023
Certification dateApril 28, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Family Health Centers Of San Diego Inc — 297 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Northridge