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Deactivated NPI 1245456417 Deactivated / Inactive NPI Male Practitioner

Dr. Desiderio C Jacob , MD

Preferred Provider Organization • Compton, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Desiderio Jacob has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 17, 2007
NPI Deactivation Date July 03, 2025
Total Practice Duration ~18 Years of Practice (2007 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Desiderio Jacob, MD was a registered Preferred Provider Organization practicing in Compton, CA. Throughout an active medical career spanning 18 years, Dr. Jacob provided care at the practice location at 2140 S SANTA FE AVE until profile deactivation on 2025-07-03.

Practice Location & Contact Primary Location

Practice Address

2140 S Santa Fe Ave

Compton, CA 902215311

Telephone 3106311107
Fax 3106316425

Specialty Benchmarks & Practice Insights

Comparative analytics for Preferred Provider Organization in Compton, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 20.0 Yrs
Regional Practice Density
1 Specialists

Practicing in Compton, CA (23 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Preferred Provider Organization Primary Specialty

NUCC Taxonomy Code: 305R00000X

State License CA A23679

A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated July 03, 2025

Record deactivated on July 03, 2025

NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 09, 2007

Registered at 2140 S SANTA FE AVE, COMPTON, CA 902215311 (Tel: 3106311107)

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Updated Business Mailing Address July 09, 2007

Registered at 960 PASEO LA CRESTA, PALOS VERDES ESTATES, CA 902742053 (Tel: 3103733868)

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Provider Name / Credentials Updated July 09, 2007

Recorded as DESIDERIO JACOB, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Preferred Provider Organization (License #A23679 in CA)

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Initial NPI Registration & Enumeration April 17, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1245456417
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 17, 2007
Last Update: July 09, 2007
Deactivation Date: July 03, 2025

Mailing Address

960 Paseo La Cresta

Palos Verdes Estates, CA 902742053

Phone: 3103733868

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.