Fakoory, Jacob John

Fakoory, Jacob John is an individual health care provider with primary practice located at 1420 S Central Ave , Glendale CA 91204-2508. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Fakoory, Jacob John can be contacted via phone (818) 502-2344.

Contact Information

Primary practice address
1420 S Central Ave Glendale CA 91204-2508
Phone: (818) 502-2344
Fax: (818) 502-4501
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X C39375 California

Profile Details

NPI number 1134160609
LBN Legal business name Fakoory, Jacob John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2006
Last updated Feb 28th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134160609 NPPES
California MEDICAID 00C393750

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