Jacob Health Care Center LP

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

090000093 Issued in CA

Legal business name

JACOB HEALTH CARE CENTER LP

Practice address

4075 54TH St
San Diego, CA 92105

Phone

(323) 556-0040

Fax

(323) 556-0048

NPI assigned

Oct 28, 2005

Organization subpart

No

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

Authorized official

Name

Jacob Graff

Title

P

Phone

(310) 286-3074

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532476800000",
    "number": "1881684900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4075 54TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921052301",
            "telephone_number": "323-556-0040",
            "fax_number": "323-556-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4075 54TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92105",
            "telephone_number": "323-556-0040",
            "fax_number": "323-556-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOB HEALTH CARE CENTER LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-28",
        "last_updated": "2018-07-25",
        "status": "A",
        "authorized_official_last_name": "GRAFF",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "P",
        "authorized_official_telephone_number": "310-286-3074"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "090000093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT055508G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy Jackson
• Troika Danielle Jackson
• Vanessa Marie Jackson, P.T.
• William Harold Jackson
• Jacob Health Care Assisted Living
• Sharon Jacob-Soo, MD
• Christopher Alan Jacob, PA-C
• Jessica Marie Jacob, LMFT
• Katherine A Jacob
• Robert B Jacob, D.D.S.

• Skilled Nursing Facility in San Diego, CA
• Providers in San Diego, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.