Healthcare Provider Details

I. General information

NPI: 1952551855
Provider Name (Legal Business Name): ADAM JONATHAN JACOBS D.C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2008
Last Update Date: 07/06/2025
Certification Date: 07/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1365 4TH ST
SAN FRANCISCO CA
94158-2201
US

IV. Provider business mailing address

1365 4TH ST
SAN FRANCISCO CA
94158-2201
US

V. Phone/Fax

Practice location:
  • Phone: 415-788-8700
  • Fax: 415-788-8702
Mailing address:
  • Phone: 415-788-8700
  • Fax: 415-788-8702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberDC-31019
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: