Active NPI
Jacob David Marcus, EMT-1
- Basic Emergency Medical Technician
- Escondido, CA
National Provider Identifier
1245568021
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Basic Emergency Medical Technician
- License
- 54935
- Practice address
- 2135 E Valley Pkwy
Escondido, CA 92027-2744 - Phone
- (818) 970-5120
- NPI assigned
- Dec 6, 2009
- Last updated
- Mar 13, 2012
- 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 |
|---|---|---|---|---|
| Basic Emergency Medical Technician | 146N00000X | 54935 | CA | Primary |
Addresses
Primary practice location
2135 E Valley Pkwy
Escondido, CA 92027-2744
Mailing address
2135 E Valley Pkwy
Escondido, CA 92027-2744
Phone (818) 970-5120
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54935 | CA | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331596800000",
"number": "1245568021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2135 E VALLEY PKWY",
"city": "ESCONDIDO",
"state": "CA",
"postal_code": "920272744",
"telephone_number": "818-970-5120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2135 E VALLEY PKWY",
"city": "ESCONDIDO",
"state": "CA",
"postal_code": "920272744",
"telephone_number": "818-970-5120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCUS",
"first_name": "JACOB",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "EMT-1",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-12-06",
"last_updated": "2012-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "146N00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Basic",
"state": "CA",
"license": "54935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Escondido, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.