Healthcare Provider Details

I. General information

NPI: 1538913173
Provider Name (Legal Business Name): NATALIA JACOBS MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2024
Last Update Date: 04/11/2024
Certification Date: 04/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28120 BRADLEY RD
MENIFEE CA
92586-2208
US

IV. Provider business mailing address

19691 CALLE LADERA
MURRIETA CA
92562-7169
US

V. Phone/Fax

Practice location:
  • Phone: 951-813-9423
  • Fax:
Mailing address:
  • Phone: 951-813-9423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NATALIA JACOBS
Title or Position: OWNER
Credential: MD
Phone: 951-813-9423