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JACK ACKERMAN DO

>> Internal Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1780794107

Individual Registrant:
 JACK  ACKERMAN DO
Gender: M
Not Sole Proprietor

Location and contact information for practice:
227 N JACKSON AVE  SAN JOSE, CA 95116-1603 US
Tel: 408-347-2002  Fax: 408-347-2189

Contact information for business:
400 RACE ST  SAN JOSE, CA 95126-3518 US
Tel: 408-278-3121  Fax: 408-278-3194

Registration Information:
NPI: 1780794107
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207R00000XAllopathic & Osteopathic Physicians
Internal Medicine
CA20A6210
N208M00000XAllopathic & Osteopathic Physicians
Hospitalist
CA20A6210

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
00AX62100CA05




HEALTH CARE JOBS CA - Page 1



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