Lucien Richard Jacobs, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

A30329 Issued in CA

Practice address

5525 Etiwanda Ave
Suite 110
Tarzana, CA 91356-3647

Phone

(818) 708-6070

Fax

(818) 889-8005

NPI assigned

Dec 21, 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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Maurice Gourdji MD Inc & Lucien R Jacobs MD Inc

  • Gastroenterology Physician
  • Tarzana, CA
  • NPI 1184600074
  NPD (past)

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1639155658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5051 OAKDALE AVE",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913643628",
            "telephone_number": "818-625-9178",
            "fax_number": "818-999-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 ETIWANDA AVE",
            "address_2": "SUITE 110",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563647",
            "telephone_number": "818-708-6070",
            "fax_number": "818-889-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "LUCIEN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A30329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "100002870",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackie Kreitzman and Associates
• Danielle Jackson
• Robert Warren Jackson
• Sebastian Sky Jacob
• Sharon Jacobs-Cohen, SLP
• David Jacobson
• Lori Ann Jager
• Amir Jahangard Mahboob
• Stephany Jaimes, BEHAVIORAL THERAPIST
• James a Danielzadeh M D

• Gastroenterology Physician in Tarzana, CA
• Providers in Tarzana, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; 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.