| Doctor Name: | JACOB M. ISHKANIAN |
| NPI Number: | 1861569675 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | C39035 |
| Business Practice Address: | 25825 Vermont Ave Harbor City, CA - 907103518 |
| Business Phone Number: | 3103255111 |
| Business Fax Number: | 3105174177 |
| Mailing Address: | 25825 Vermont Ave, HARBOR CITY |
| State: | CA |
| Postal Code: | 907103518 |
| Phone Number: | 3103255111 |
| Fax Number: | 3105174177 |
| NPI Enumeration Date: | 11/29/2006 |
| NPI Last Update Date: | 06/09/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204D00000X |
| License Number: | C39035 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |