DR. JACOB H FENNESSY (NPI# 1972923704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972923704 |
| Entity Type | Individual |
| Full Name | DR. JACOB H FENNESSY |
| Credential | M.D. |
| Practice Address |
200 W Arbor Dr San Diego CA 92103 |
| Mailing Address |
Po Box 232410 San Diego CA 92193-2410 |
| Practice Telephone | 8009268273 |
| Enumeration Date | 2014-04-20 |
| Last Update Date | 2019-07-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
A141175 | CA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4860 Y St, Ste 3800, Sacramento, CA 958172307 | 9167342807 |
| Street Address |
200 W ARBOR DR |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043215502 | Alfredo B. Tiu | Internal Medicine | 200 W Arbor Dr, Owen Clinic, San Diego, CA 92103-9001 | 2005-06-20 |
| 1841806536 | Kevin Thai Nguyen | Pharmacist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-09-18 |
| 1003421256 | Jessica Lynette Montoya | Psychologist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-09-14 |
| 1013522838 | Julianna L Gorder | Psychologist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-09-09 |
| 1992318828 | Yodit Mekonnen Teklu | Pharmacist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-08-29 |
| 1356954283 | Dalia Siada | Dietitian, Registered | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-08-29 |
| 1699383588 | Rachael Ashley Gordon | Pharmacist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-07-17 |
| 1124646906 | Jeffrey David Bernstein | Student in an Organized Health Care Education/Training Program | 200 W Arbor Dr, Mc 1234, San Diego, CA 92103-9000 | 2020-07-08 |
| 1639796071 | Darcie D Brown | Marriage & Family Therapist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-07-01 |
| 1194340919 | Han B Dinh | Pharmacist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
| Find all providers in zip 92103 | ||||
| Taxonomy Code | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730508979 | Abhiram Gande | Orthopaedic Surgery | 7485 Mission Valley Rd Ste 104a, San Diego, CA 92108-4422 | 2014-04-15 |
| 1659713725 | Nicole Claudette Record | Orthopaedic Surgery | 6190 Cornerstone Ct E Ste 212, San Diego, CA 92121-4701 | 2013-07-18 |
| 1073677811 | La Jolla Spine Institute Medical Group, Inc. | Orthopaedic Surgery | 6719 Alvarado Rd., Suite 308, San Diego, CA 92120 | 2006-12-19 |
| 1245281856 | Jean-jacques Abitbol | Orthopaedic Surgery | 7625 Mesa College Dr Ste 310a, San Diego, CA 92111-5343 | 2006-05-16 |
| 1962018044 | Excel Spine Center | Orthopaedic Surgery | 6719 Alvarado Rd Ste 308, San Diego, CA 92120-5268 | 2020-09-23 |
| 1114306347 | Preetpaul Singh Bagi | Orthopaedic Surgery | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2015-05-20 |
| 1629456553 | John D Attenello | Orthopaedic Surgery | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2015-05-12 |
| 1285952655 | Oliver O Tannous | Orthopaedic Surgery | 350 Dickinson St, Suite 121, Mc 8894, San Diego, CA 92103-1913 | 2010-05-11 |
| 1760632947 | Ali Bagheri | Orthopaedic Surgery | 9333 Genesee Ave Ste 350, San Diego, CA 92121-2103 | 2008-09-24 |
| 1639336043 | Paul Dohyung Kim | Orthopaedic Surgery | 6719 Alvarado Road, Suite 308, San Diego, CA 92120 | 2008-05-22 |
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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.