Jacob M Tsadok MD Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A61419 Issued in CA

Legal business name

JACOB M TSADOK MD INC

Practice address

9808 Venice Blvd Ste 603
Culver City, CA 90232-6819

Phone

(310) 966-7920

Fax

(310) 652-4053

NPI assigned

Jun 3, 2014

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jacob M Tsadok, M.D.NPI 1881756096

Title

Owner/Ceo

Phone

(310) 966-7920

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

Jacob M Tsadok MD Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Jacob M. Tsadok M.D. Inc

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1629258520
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jacob M Tsadok, MD

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1881756096
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1861805335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24971",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900240971",
            "telephone_number": "310-277-9010",
            "fax_number": "310-652-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9808 VENICE BLVD STE 603",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902326819",
            "telephone_number": "310-966-7920",
            "fax_number": "310-652-4053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOB M TSADOK MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-03",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "TSADOK",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "310-966-7920",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A61419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A61419",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ladale Jackson Sr.
• Shirley Jackson
• Symone Jackson, LCSW
• Tashe'E Marie Jackson
• Yvette Antoinette Jackson, LCSW
• Jeena Jacob, APRN
• Andrea Jacobo
• Clarissa Jacobo
• Evelyn Jacobo
• Lizbeth Jacobo

• Internal Medicine Physician in Culver City, CA
• Providers in Culver City, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.