Edwin Lee Jacobs (NPI# 1366462939, PAC ID# 3072543966) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is HEMATOLOGY/ONCOLOGY.
| Nation Provider ID (NPI) | 1366462939 |
| PAC ID by PECOS | 3072543966 |
| Professional Enrollment ID | I20111207000390 |
| Full Name | Edwin Lee Jacobs |
| Organization Legal Name | PROVIDENCE MEDICAL INSTITUTE |
| Address |
2121 Santa Monica Blvd Santa Monica CA 90404-2303 |
| Phone Number | 3105827450 |
| Gender | M |
| Medical School | UNIVERSITY OF CALIFORNIA, UCLA SCHOOL OF MEDICINE |
| Graduation Year | 1985 |
| Primary Specialty | HEMATOLOGY/ONCOLOGY |
| Secondary Specialties | INTERNAL MEDICINE |
| Group Practice PAC ID | 5991609737 |
| Number of Group Practice Members | 250 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050235 | PROVIDENCE SAINT JOSEPH MEDICAL CTR |
| Address | Phone | Organization |
|---|---|---|
| 181 S Buena Vista St, Burbank, CA 91505-4504 | PROVIDENCE MEDICAL INSTITUTE | |
| 501 S Buena Vista St, Burbank, CA 91505-4809 | 8188473022 | PROVIDENCE MEDICAL INSTITUTE |
| 21501 Avalon Blvd, Suite 100, Carson, CA 90745-2210 | 3108356627 | PROVIDENCE MEDICAL INSTITUTE |
| 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 | 3105827450 | PROVIDENCE MEDICAL INSTITUTE |
| Organization Legal Name | PROVIDENCE MEDICAL INSTITUTE |
| Physicians | 252 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lisa A Garner | Nurse Practitioner | Providence Medical Institute | 24035 Newhall Ranch Rd, Santa Clarita, CA 91355-5702 |
| Jennifer S Lee | Nurse Practitioner | Providence Medical Institute | 12618 Hawthorne Blvd, Hawthorne, CA 90250-3907 |
| Danielle N Anderson | Obstetrics/gynecology | Providence Medical Institute | 2601 W Alameda Avenue, Suite 212, Burbank, CA 91505-4800 |
| Julie A Gould | Obstetrics/gynecology | Providence Medical Institute | 405 N Maclay Ave, Suite 104, San Fernando, CA 91340-2455 |
| Reza Askari | Obstetrics/gynecology | Providence Medical Institute | 621 S Butte St, San Pedro, CA 90732-3510 |
| Brenda Shen | Family Medicine | Providence Medical Institute | 2382 Crenshaw Blvd, Suite 5, Torrance, CA 90501-3333 |
| Raj U Dugel | Ophthalmology | Providence Medical Institute | 4825 Torrance Blvd, Suite 100, Torrance, CA 90503-4167 |
| Jeffrey Work | Interventional Cardiology | Providence Medical Institute | 21501 Avalon Blvd, Suite 100, Carson, CA 90745-2210 |
| Peter J Georgio Ii | Family Medicine | Providence Medical Institute | 1010 N Sepulveda Blvd, Manhattan Beach, CA 90266-5929 |
| Michael M Marvi | Neurology | Providence Medical Institute | 1870 Veteran Ave, Apt 102, Los Angeles, CA 90025-4569 |
| Street Address |
2121 SANTA MONICA BLVD |
| City | SANTA MONICA |
| State | CA |
| Zip | 90404-2303 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mina Kang | Internal Medicine | Providence Saint Johns Medical Foundation | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 |
| Sean Dooley | Internal Medicine | Inpatient Specialists of California PC | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 |
| Yuki Takasumi | Pathology | Pathology Medical Group of Saint John's | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 |
| Marissa L Zobrist | Emergency Medicine | Saint Johns Emergency Medicine Specialists Inc A Medical Group | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 |
| Judy D Truong | Physician Assistant | Providence Saint Johns Medical Foundation | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 |
| Janie Gia-lin Weng Grumley | General Surgery | Providence Saint Johns Medical Foundation | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 |
| Peter A Elliott | Urology | Providence Saint Johns Medical Foundation | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 |
| Frederick R Singer | Internal Medicine | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 | |
| Lucia Nicole Dobrawa | Physician Assistant | Providence Saint Johns Medical Foundation | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 |
| Yalda B Naeini | Pathology | Pathology Medical Group of Saint John's | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Vivanti N Jain | Plastic and Reconstructive Surgery | 2021 Santa Monica Blvd, Santa Monica, CA 90404-0001 | |
| Margaret Ann Regan Rainey | Nurse Practitioner | Regents of The University of California | 1225 15th St, Suite 2100, Santa Monica, CA 90404-1101 |
| Ralph A Massey | Dermatology | 1260 15th St, Suite 1401, Santa Monica, CA 90404-1106 | |
| Peter Galier | Internal Medicine | Premier Health Partners of Santa Monica | 1260 15th St, Suite 1415, Santa Monica, CA 90404-1135 |
| John Patrick Whelan | Rheumatology | The Regents of The University of California | 1260 15th St, Suite 1502, Santa Monica, CA 90404-1135 |
| Melissa D Alexander | Qualified Audiologist | 1260 15th St, P2, Santa Monica, CA 90404-1135 | |
| Malena Shu-chuan Law | General Practice | Premier Health Partners of Santa Monica | 1260 15th St, Suite 1415, Santa Monica, CA 90404-1135 |
| Mohammed Fahad Ali | Internal Medicine | The Regents of The University of California | 1260 15th St, Suite 1502, Santa Monica, CA 90404-1135 |
| Manoochehr Yashari | Obstetrics/gynecology | 1260 15th St, Suite 616, Santa Monica, CA 90404-1141 | |
| Quynhtrang Le Sebastian | Dermatology | 1260 15th St, Suite 709, Santa Monica, CA 90404-1142 | |
| Find all physicians in zip 90404 | |||
| City | SANTA MONICA |
| Zip Code | 90404 |
| Specialty | HEMATOLOGY/ONCOLOGY |
| City + Specialty | SANTA MONICA + HEMATOLOGY/ONCOLOGY |
Please comment or provide details below to improve the information on Edwin Lee Jacobs.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.