Active NPI
Jacob Goldman
- Occupational Therapist
- Los Angeles, CA
National Provider Identifier
1285950220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 11171
- Practice address
- 1111 W 6TH St
Suite 111
Los Angeles, CA 90017-1800 - Phone
- (323) 404-1027
- Fax
- (323) 340-8298
- NPI assigned
- Apr 15, 2010
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 11171 | CA | Primary |
Addresses
Primary practice location
1111 W 6TH St
Suite 111
Los Angeles, CA 90017-1800
Mailing address
625 Fair Oaks Ave
Suite 200
South Pasadena, CA 91030-2630
Phone (323) 404-1027
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271289600000",
"number": "1285950220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 FAIR OAKS AVE",
"address_2": "SUITE 200",
"city": "SOUTH PASADENA",
"state": "CA",
"postal_code": "910302630",
"telephone_number": "323-404-1027",
"fax_number": "323-340-8298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 W 6TH ST",
"address_2": "SUITE 111",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900171800",
"telephone_number": "323-404-1027",
"fax_number": "323-340-8298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDMAN",
"first_name": "JACOB",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-04-15",
"last_updated": "2010-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "11171",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.