Active NPI
Arash Jacob, D.O.
- Public Health & General Preventive Medicine Physician
- Santa Monica, CA
National Provider Identifier
1366565624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- 20A7955
- Practice address
- 2128 Pico Blvd
Santa Monica, CA 90405-1718 - Phone
- (310) 664-8818
- Fax
- (310) 664-8878
- NPI assigned
- Apr 9, 2007
- 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 |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | 20A7955 | CA | Primary |
Addresses
Primary practice location
2128 Pico Blvd
Santa Monica, CA 90405-1718
Mailing address
2128 Pico Blvd
Santa Monica, CA 90405-1718
Phone (310) 664-8818
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Mar 8, 2017 through Mar 8, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7955 | CA | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366565624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2128 PICO BLVD",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904051718",
"telephone_number": "310-664-8818",
"fax_number": "310-664-8878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2128 PICO BLVD",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904051718",
"telephone_number": "310-664-8818",
"fax_number": "310-664-8878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOB",
"first_name": "ARASH",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "CA",
"license": "20A7955",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.