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NPI Code Detail

MEDICARE: STEVEN R JACOBS M.D.

MEDICARE: STEVEN R JACOBS 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
1174400000XSpecialistG38027CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100A316020OTHERCADHS PPIN

General Provider Information

NPI Number : 1811956758
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN R JACOBS M.D.
Provider Business Mailing Address
First Line : PO BOX 10076
Second Line :
City : VAN NUYS
State : CA
Zip : 91410-0076
Country : US
Telephone Number : 805-578-8300
Fax Number : 805-578-8950
Provider Business Practice Location Address
First Line : 2615 EYE ST
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93301-2006
Country : US
Telephone Number : 661-336-0622
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2006
Last Update Date : 07/08/2007

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