Deane B. Jacques, M.D., Inc.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

DEANE B. JACQUES, M.D., INC.

Practice address

637 Lucas Ave
Ste. 501
Los Angeles, CA 90017-1912

Phone

(626) 414-4094

Fax

(626) 804-3344

NPI assigned

Dec 17, 2010

Last updated

Dec 17, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Deane B Jacques, M.D.

Title

President

Phone

(626) 414-4094

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1292544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292544000000",
    "number": "1083917736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 LUCAS AVE",
            "address_2": "STE. 501",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171912",
            "telephone_number": "626-414-4094",
            "fax_number": "626-804-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 LUCAS AVE",
            "address_2": "STE. 501",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171912",
            "telephone_number": "626-414-4094",
            "fax_number": "626-804-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEANE B. JACQUES, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-17",
        "last_updated": "2010-12-17",
        "status": "A",
        "authorized_official_last_name": "JACQUES",
        "authorized_official_first_name": "DEANE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-414-4094",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Dean
• Steven Dean, CADC II
• Suyama Ruth Dean, LVN
• Umeko Lotus Dean
• Richard A. Deandrea, M.D., N.D.
• Joseph Deangelo, ASW
• Deanna Dow, PHD, Inc (Spectrum Psych Los Angeles)
• Matthew Deardorff, MD, PHD
• Rosemary D Dearnley, RN
• Trier M Dearth

• Ambulatory Surgical Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.