NPIMap

Organization Active NPI

Dr. G Garry Yacoub OD

  • Point of Service
  • Concord, CA
National Provider Identifier
1205959673
Registry record updated Jan 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
05621 Issued in CA
Legal business name
DR. G GARRY YACOUB OD
Practice address
1460 Washington Blvd
A101
Concord, CA 94521-4048
Phone
(925) 672-4100
NPI assigned
Apr 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2008

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

Authorized official

Name
Mr. G Garry Yacoub, OD
Title
Owner
Phone
(925) 672-4100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X 05621 CA Primary

Addresses

Primary practice location

1460 Washington Blvd
A101
Concord, CA 94521-4048

Mailing address

1460 Washington Blvd
A101
Concord, CA 94521-4048
Phone (925) 672-4100

National Provider Directory

National Provider Directory

Locations

1460 Washington Blvd
Ste A101
Concord, CA 94521
Phone (925) 672-4100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200009600000",
    "number": "1205959673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 WASHINGTON BLVD",
            "address_2": "A101",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945214048",
            "telephone_number": "925-672-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 WASHINGTON BLVD",
            "address_2": "A101",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945214048",
            "telephone_number": "925-672-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. G GARRY YACOUB OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2008-01-11",
        "status": "A",
        "authorized_official_last_name": "YACOUB",
        "authorized_official_first_name": "G",
        "authorized_official_middle_name": "GARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "925-672-4100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "CA",
            "license": "05621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.

Verify at the official NPI Registry.