Jack Jue Jr., M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G34658 Issued in CA

Practice address

8170 Laguna Blvd
Suite 113
Elk Grove, CA 95758-7901

Phone

(916) 478-6561

Fax

(916) 478-6573

NPI assigned

Nov 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1497738306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8170 LAGUNA BLVD",
            "address_2": "SUITE 113",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587901",
            "telephone_number": "916-478-6561",
            "fax_number": "916-478-6573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUE",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G34658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G346580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Daniel Juarros Jr., DDS
• Janice C Judson, NP
• Jacob Juico
• Lilian Atieno Juma, RN
• Betty Jung, MSW
• Alison L Juozokas, M.D.
• Keelynn Kaalekahi

• Family Medicine Physician in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; 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.