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NPI Code Detail

MEDICARE: JACOB HENRY JAFFE DPT

MEDICARE: JACOB HENRY JAFFE DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist297641CA
2225100000XPhysical TherapistP21096NC

General Provider Information

NPI Number : 1932743515
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACOB HENRY JAFFE DPT
Provider Business Mailing Address
First Line : 10474 SANTA MONICA BLVD STE 435
Second Line :
City : LOS ANGELES
State : CA
Zip : 90025-6932
Country : US
Telephone Number : 310-275-4137
Fax Number :
Provider Business Practice Location Address
First Line : 2000 BRABHAM AVE STE 100
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-0202
Country : US
Telephone Number : 910-332-3800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2019
Last Update Date : 03/10/2022

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Directions to “ JACOB HENRY JAFFE DPT” Practice Location

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