Active NPI
Alan Jacobs, M.D., PH.D.
- General Practice Physician
- Palo Alto, CA
National Provider Identifier
1407169345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- G083705
- Practice address
- 3721 Ortega CT
Palo Alto, CA 94303-4451 - Phone
- (650) 575-5260
- Fax
- (650) 230-7130
- NPI assigned
- Jul 21, 2010
- 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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | G083705 | CA | Primary |
Addresses
Primary practice location
3721 Ortega CT
Palo Alto, CA 94303-4451
Mailing address
3721 Ortega CT
Palo Alto, CA 94303-4451
Phone (650) 575-5260
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
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G083705 | CA | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279670400000",
"number": "1407169345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3721 ORTEGA CT",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943034451",
"telephone_number": "650-575-5260",
"fax_number": "650-230-7130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3721 ORTEGA CT",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943034451",
"telephone_number": "650-575-5260",
"fax_number": "650-230-7130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "ALAN",
"name_prefix": "Dr.",
"credential": "M.D., PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-07-21",
"last_updated": "2010-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "CA",
"license": "G083705",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palo Alto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.