Jacob Manjooran, MD, P.C.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

11276 Issued in NV

Legal business name

JACOB MANJOORAN, MD, P.C.

Practice address

3680 E Sunset Rd Ste 100
Las Vegas, NV 89120-7219

Phone

(702) 855-0748

Fax

(702) 486-4531

NPI assigned

Apr 25, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Jacob Manjooran, MD

Title

Owner

Phone

(702) 480-7825

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370217600000",
    "number": "1720346828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2679 BOTHWELL PL",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890444400",
            "telephone_number": "702-480-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3680 E SUNSET RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891207219",
            "telephone_number": "702-855-0748",
            "fax_number": "702-486-4531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOB MANJOORAN, MD, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-25",
        "last_updated": "2013-06-03",
        "status": "A",
        "authorized_official_last_name": "MANJOORAN",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-480-7825",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NV",
            "license": "11276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "CC7754",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100506295",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yurnell Dianne Jackson
• Yvonne Jackson
• Yvonne Jackson
• Yvonne Ruth Jackson
• Zenobia Antonette Jackson
• Jasmine Jacob, APRN
• Jimmy Jacob
• Linah Shamba Jacob
• Ryan E Jacob, RN
• Steven M Jacob

• Psychiatry Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Psychiatry Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; 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.