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NPI Code Detail

MEDICARE: DR. LON JACOBUS TAFF M.D.

MEDICARE: DR. LON JACOBUS TAFF M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology PhysicianC54503CA

General Provider Information

NPI Number : 1548254295
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LON JACOBUS TAFF M.D.
Provider Business Mailing Address
First Line : 1723 11TH AVE
Second Line :
City : SACRAMENTO
State : CA
Zip : 95818-4140
Country : US
Telephone Number : 916-764-5627
Fax Number :
Provider Business Practice Location Address
First Line : 6600 BRUCEVILLE RD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95823-4671
Country : US
Telephone Number : 916-764-5627
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2005
Last Update Date : 02/11/2022

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