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Organization

J. BRUCE JACOBS, MD, INC

Active
Other names
DOWNEY RADIOLOGY
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALEXANDER USMANOV M.D. (PRESIDENT)
(562) 904-1111
Entity
Organization

Contact information

Practice address
11525 BROOKSHIRE AVE, SUITE 111, DOWNEY, CA 90241-4985
(562) 904-1111
(562) 861-6666
Mailing address
11525 BROOKSHIRE AVE, SUITE 111, DOWNEY, CA 90241-4985
(562) 904-1111
(562) 861-6666

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A21604
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1215230297
CA
Enumeration date
12/13/2010
Last updated
01/28/2014
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