Richard Jacob, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

G22936 Issued in CA

Practice address

26800 Crown Valley Pkwy
Suite 250
Mission Viejo, CA 92691-6384

Phone

(949) 364-3570

Fax

(949) 364-3430

NPI assigned

Dec 26, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1135555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1093792640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26522 LA ALAMEDA",
            "address_2": "SUITE 120",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916330",
            "telephone_number": "949-282-1671",
            "fax_number": "949-367-0518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26800 CROWN VALLEY PKWY",
            "address_2": "SUITE 250",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916384",
            "telephone_number": "949-364-3570",
            "fax_number": "949-364-3430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-26",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G22936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G229360",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackson Moses, DDS, Inc
• Melissa Jackson
• Mia Lanise Jackson, LVN
• Jaclyn Nobakht Pmhnp-BC Psychiatric Nursing Services Inc
• Anita Joy Jacob, MS
• Joanna R Jacobo
• Jae H. Lee MD Inc
• Susan Jane Jaeckel, B.A.
• Fatemeh Jafari Farshami, M.D.
• Zahra Jafarian-Blourchian, SLP

• Cardiovascular Disease Physician in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; 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.