Eddie Jacobo

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

C51396 Issued in MD

Practice address

2609 W Beverly Blvd Ste 3
Montebello, CA 90640-2300

Phone

(909) 342-8951

NPI assigned

Jun 8, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Mr. Eddie L Jacobo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hope Artificial Limb & Brace,LLC

  • Prosthetic/Orthotic Supplier
  • Montebello, CA
  • NPI 1992165815
  NPD (past)

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

{
    "created_epoch": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1700266434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 W BEVERLY BLVD STE 3",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906402300",
            "telephone_number": "909-342-8951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 W BEVERLY BLVD STE 3",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906402300",
            "telephone_number": "909-342-8951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBO",
        "first_name": "EDDIE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-08",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "MD",
            "license": "C51396",
            "primary": false
        },
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "MD",
            "license": "C51396",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "MD",
            "license": "C51396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDDIE",
            "last_name": "JACOBO",
            "middle_name": "L",
            "prefix": "MR.",
            "credential": "BOCPO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Estibaliz M Iturralde
• Eleana Maria Izquierdo
• J. Antonio Alarcon, MD Inc
• J. Eduardo Guzman,MD,. Inc.
• Jack C. Ling M.D. Inc.
• Jerry Jacobs, M.D.
• Jadid Montazeri D.D.S. Dental, Corp.
• Ali Jadid
• Golriz Jafari, MD
• Shadi Jahangard-Mahboob, PT, DPT

• Customized Equipment (DME) in Montebello, CA
• Providers in Montebello, CA by specialty
• Customized Equipment (DME) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.