Jacqueline Bracy, M.D., Inc.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

C043356 Issued in CA

Legal business name

JACQUELINE BRACY, M.D., INC.

Practice address

412 W Carroll Ave
Suite 107
Glendora, CA 91741-4240

Phone

(626) 852-0411

Fax

(626) 852-0407

NPI assigned

Aug 24, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jacqueline Bracy, M.D.

Title

President

Phone

(626) 852-0411

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1314144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314144000000",
    "number": "1043590912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1418",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917401418",
            "telephone_number": "626-852-0411",
            "fax_number": "626-852-0407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 W CARROLL AVE",
            "address_2": "SUITE 107",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414240",
            "telephone_number": "626-852-0411",
            "fax_number": "626-852-0407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACQUELINE BRACY, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-24",
        "last_updated": "2011-08-24",
        "status": "A",
        "authorized_official_last_name": "BRACY",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-852-0411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "C043356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Glendora, CA
• Providers in Glendora, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.