Provider Demographics
NPI:1629825237
Name:AP JAKUBOWSKI MD INC
Entity type:Organization
Organization Name:AP JAKUBOWSKI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:JAKUBOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-281-5954
Mailing Address - Street 1:3479 GRAVINA PL
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-6272
Mailing Address - Country:US
Mailing Address - Phone:209-281-5954
Mailing Address - Fax:
Practice Address - Street 1:3479 GRAVINA PL
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-6272
Practice Address - Country:US
Practice Address - Phone:209-281-5954
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty