Active NPI
John R Jacomo, MD
- Family Medicine Physician
- Fountain Valley, CA
National Provider Identifier
1083757827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G51493
- Practice address
- 9930 Talbert Ave
Fountain Valley, CA 92708 - Phone
- (714) 964-6229
- Fax
- (714) 378-6233
- NPI assigned
- Feb 14, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G51493 | CA | Primary |
Addresses
Primary practice location
9930 Talbert Ave
Fountain Valley, CA 92708
Mailing address
1665 Scenic Ave
Ste 100
Costa Mesa, CA 92626
Phone (714) 436-4444
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Talbert Medical Group, P.C. | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Talbert Medical Group
- Internal Medicine Physician
- Fountain Valley, CA
- NPI 1528069176
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220832000000",
"number": "1083757827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1665 SCENIC AVE",
"address_2": "STE 100",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "92626",
"telephone_number": "714-436-4444",
"fax_number": "714-436-4812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9930 TALBERT AVE",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "92708",
"telephone_number": "714-964-6229",
"fax_number": "714-378-6233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOMO",
"first_name": "JOHN",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-14",
"last_updated": "2008-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G51493",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fountain Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.