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General NPI Number Information
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NPI Number | 1366617177
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Entity Type | Organization
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Legal Business Name | JACOB E TAUBER MD A PROFESSIONAL
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Dates
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Enumeration Date | 04/23/2008
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Last Update Date | 03/20/2014
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Provider Practice Location Address
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Address Line | 1505 WILSON TER SUITE 310
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City | GLENDALE
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State | CA
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Zip | 91206-4071
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Country | US
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Telephone | 818-502-1130
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Fax | 818-502-9031
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Provider Business Mailing Address
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Address Line | 9033 WILSHIRE BLVD SUITE 401
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-1837
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Country | US
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Telephone | 310-273-1003
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Fax | 310-273-2551
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Authorized Official
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Title or Position | PHYSICIAN SURGEON
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Name | DR. JACOB E TAUBER
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Credential | M.D.
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Telephone | 310-273-1003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | G41526
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License Number State | CA
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