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Organization Active NPI

Gary Alan Jacob Chiropractic Inc

  • Rehabilitation Chiropractor
  • Los Angeles, CA
National Provider Identifier
1073844494
Registry record updated Jan 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
12432 Issued in CA
Legal business name
GARY ALAN JACOB CHIROPRACTIC INC
Practice address
10474 Santa Monica Blvd
# 304
Los Angeles, CA 90025-6929
Phone
(310) 339-6009
Fax
(310) 470-7557
NPI assigned
Jan 25, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2010

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

Authorized official

Name
Dr. Gary Alan Jacob, DC, LAC, MPH
Title
Pres
Phone
(310) 339-6009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NR0400X 12432 CA Primary

Addresses

Primary practice location

10474 Santa Monica Blvd
# 304
Los Angeles, CA 90025-6929

Mailing address

10474 Santa Monica Blvd
# 304
Los Angeles, CA 90025-6929
Phone (310) 339-6009

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1264377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264377600000",
    "number": "1073844494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10474 SANTA MONICA BLVD",
            "address_2": "# 304",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256929",
            "telephone_number": "310-339-6009",
            "fax_number": "310-470-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10474 SANTA MONICA BLVD",
            "address_2": "# 304",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256929",
            "telephone_number": "310-339-6009",
            "fax_number": "310-470-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY ALAN JACOB CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-25",
        "last_updated": "2010-01-25",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "310-339-6009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC, LAC, MPH"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CA",
            "license": "12432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2010; 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.