DEANE B. JACQUES M.D. INC. NPI 1083917736

NPI Information

  • NPI: 1083917736
  • Provider Name: DEANE B. JACQUES, M.D., INC.
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • Address: 637 LUCAS AVE
    STE. 501
    LOS ANGELES, CA
    ZIP 90017
  • Phone: (626) 414-4094

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NPI Details

DEANE B. JACQUES, M.D., INC. is an ambulatory surgical clinic center in Los Angeles, CA. DEANE B. JACQUES, M.D., INC. NPI is 1083917736. The provider is registered as an organization entity type.

The provider's business location address is:

637 LUCAS AVE
STE. 501
LOS ANGELES, CA
ZIP 90017-912
Phone: (626) 414-4094
Fax: (626) 804-3344

The provider's authorized official is Deane B Jacques .
The authorized official title is President and has the following contact phone number (626) 414-4094.

The enumeration date for this NPI number is 12/17/2010 and was last updated on 12/17/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QA1903XClinic/CenterAmbulatory SurgicalYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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