| Jacob M Tsadok Md Inc | |
|
9808 Venice Blvd Ste 603 Culver City CA 90232-6819 | |
| (310) 966-7920 | |
| (310) 652-4053 |
| Full Name | Jacob M Tsadok Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9808 Venice Blvd Ste 603, Culver City, California |
| Authorized Official Name and Position | Jacob M Tsadok (OWNER/CEO) |
| Authorized Official Contact | 3109667920 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacob M Tsadok Md Inc Po Box 24971 Los Angeles CA 90024-0971 Ph: (310) 277-9010 | Jacob M Tsadok Md Inc 9808 Venice Blvd Ste 603 Culver City CA 90232-6819 Ph: (310) 966-7920 |
| NPI Number | 1861805335 |
|---|---|
| Provider Enumeration Date | 06/03/2014 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 4688890643 |
|---|---|
| Medicare Enrollment ID | O20140728001742 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861805335 | NPI | - | NPPES |
| A61419 | Other | CA | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A61419 (California) | Primary |
| Provider Name | Jacob Tsadok |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881756096 PECOS PAC ID: 1759410715 Enrollment ID: I20100601000182 |
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