Jacob John Fakoory, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

C39375 Issued in CA

Practice address

1420 S Central Ave
Glendale, CA 91204-2508

Phone

(818) 502-2344

Fax

(818) 502-4501

NPI assigned

Jun 8, 2006

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Michael S. Agron, M.D., Inc.

  • Emergency Medicine Physician
  • Arcadia, CA
  • NPI 1699716100
  Medicare reassignment NPD
• Glendale Emergency Medical Associates, Inc

  • Emergency Medicine Physician
  • Glendale, CA
  • NPI 1588606834
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204156800000",
    "number": "1134160609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1227 ARNO DR",
            "city": "SIERRA MADRE",
            "state": "CA",
            "postal_code": "910241568",
            "telephone_number": "626-355-8121",
            "fax_number": "626-355-8987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 S CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042508",
            "telephone_number": "818-502-2344",
            "fax_number": "818-502-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKOORY",
        "first_name": "JACOB",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2008-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "C39375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C393750",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony Faggioli IV, AMFT
• Faith & Life Hospice Inc
• Faith in Action Project
• Jorge Fajardo
• Tracy-Jane Luyun Fajota, AGACNP-BC
• Family & Friends Home Health Care Inc
• Family Care CLHF, Inc.
• Family Counseling and Guidance Corp
• Family Hospice Services, Inc.
• Family Medicine Physicians of Glendale

• Emergency Medicine Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.