Healthcare Provider Details

I. General information

NPI: 1235309873
Provider Name (Legal Business Name): STEVEN S JACOBS MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2008
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2405 SHADELANDS DR
WALNUT CREEK CA
94598-2444
US

IV. Provider business mailing address

DEPT 34247 PO BOX 39000
SAN FRANCISCO CA
94139-0001
US

V. Phone/Fax

Practice location:
  • Phone: 925-939-8585
  • Fax:
Mailing address:
  • Phone: 800-275-8752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVEN S JACOBS
Title or Position: PRESIDENT
Credential: MD
Phone: 503-372-2740