MR. ROBERT STEPHEN JACK (NPI# 1154338515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154338515 |
| Entity Type | Individual |
| Full Name | MR. ROBERT STEPHEN JACK |
| Credential | M.D. |
| Practice Address |
8717 La Tijera Blvd Los Angeles CA 90045-3906 |
| Practice Telephone | 3106454393 |
| Practice Fax Number | 3106454508 |
| Mailing Telephone | 3106454393 |
| Mailing Fax Number | 3106454508 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | A63108 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023429057 | Robert Alan Jack II | Student in an Organized Health Care Education/Training Program | 6565 Fannin Street, Mgj9-the Methodist Hospital, Graduate Medical Education, Houston, TX 77030 | 2014-05-13 |
| 1104804764 | Robert A Jack | Psychiatry & Neurology | 2010 Quail Hollow Cir, Franklin, TN 37067-5967 | 2006-01-04 |
| 1366073579 | Robert Eric Jack | Occupational Therapy Assistant | 2600 Compass Rd, Glenview, IL 60026-8001 | 2020-01-28 |
| 1376601443 | Robert Lionel Jack | Specialist | 1225 Crane St, Menlo Park, CA 94025-4257 | 2006-12-04 |
| Street Address |
8717 LA TIJERA BLVD |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90045-3906 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770868564 | Michael Gadsby, M.d., Incorporated | Ophthalmology | 8717 La Tijera Blvd, Los Angeles, CA 90045-3906 | 2011-10-12 |
| 1194901587 | Lawrence T. Goodwin, Jr., M.d., Inc | Ophthalmology | 8717 La Tijera Blvd, Los Angeles, CA 90045-3906 | 2008-01-15 |
| 1457549941 | Michael Owen Gadsby | Ophthalmology | 8717 La Tijera Blvd, Los Angeles, CA 90045-3906 | 2007-10-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396388849 | Laska Dental Inc | Dentist | 5602 W Manchester Ave, Los Angeles, CA 90045 | 2019-10-28 |
| 1245889179 | Ana Arias | Physical Therapist | 6801 Terrace Drive, Suite 200, Los Angeles, CA 90045 | 2019-09-04 |
| 1144719410 | Family Dental Care 4 You | Dentist | 5602 W. Manchester Ave, Los Angeles, CA 90045 | 2018-05-02 |
| 1821504002 | Rhonda Taylor | Counselor | 8703 La Tijera Blvd Ste 201, Los Angeles, CA 90045 | 2017-12-24 |
| 1114436839 | Blanca Melisa Gomez I | Case Manager/Care Coordinator | 7423 1/4 S Sepulveda Blvd, Los Angeles, CA 90045 | 2017-09-26 |
| 1639688831 | Kalila Magbanua-stein | Counselor | 8618 La Tijera Blvd., Suite 200, Los Angeles, CA 90045 | 2017-09-20 |
| 1568984185 | Angela Mull | Marriage & Family Therapist | 8616 Latijera Blvd, Suite 307, Los Angeles, CA 90045 | 2017-07-14 |
| 1386171585 | Patricia Ann Bridewell | Registered Nurse | 5245 Concourse Drive, Suite 100, Los Angeles, CA 90045 | 2017-05-18 |
| 1679937627 | Thelese Consulting Group | Community/Behavioral Health | 8929 S. Sepulveda Blvd, Suite 400, Los Angeles, CA 90045 | 2016-04-06 |
| 1568823318 | Keith Romalis Ellison | Specialist/Technologist | One Lmu Drive, Gersten Pavilion - Athletic Training Room, Los Angeles, CA 90045 | 2016-03-08 |
| Find all providers in zip 90045 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407473754 | Janet K. Kim Md, Inc | Ophthalmology | 903 Crenshaw Blvd Ste 105, Los Angeles, CA 90019-1972 | 2020-07-02 |
| 1770048266 | Luxi Optometry, Inc | Ophthalmology | 3250 W. Olympic Blvd #221, Los Angeles, CA 90006 | 2019-02-08 |
| 1598238784 | Stanley S Kim Md, Inc | Ophthalmology | 3663 W 6th St Ste 200, Los Angeles, CA 90020-3048 | 2019-01-10 |
| 1811462542 | Eyecare Specialists Medical Group, Inc | Ophthalmology | 5120 W Goldleaf Cir Ste 20, Los Angeles, CA 90056-1292 | 2018-10-09 |
| 1386132744 | Masket Foundation Clinic for Eye Care | Ophthalmology | 2080 Century Park E Ste 911, Los Angeles, CA 90067-2012 | 2018-05-01 |
| 1922501154 | Maloney-shamie Vision Institute | Ophthalmology | 10921 Wilshire Blvd Ste 900, Los Angeles, CA 90024-4003 | 2018-03-14 |
| 1417484213 | Julie You Kwon Md Inc | Ophthalmology | 932 S Cloverdale Ave, Los Angeles, CA 90036-4817 | 2017-05-11 |
| 1932581642 | Eric Shieh | Ophthalmology | 100 Stein Plz Rm 2-132, Los Angeles, CA 90095-7065 | 2015-06-18 |
| 1275950115 | Daniel Lemor | Ophthalmology | 4036 Whittier Blvd Ste 202, Los Angeles, CA 90023 | 2014-03-27 |
| 1659705705 | Martin James Brickman | Ophthalmology | 2531 Mount Beacon Ter, Los Angeles, CA 90068-2444 | 2013-08-26 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90045 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.