# JERRY MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548357288
- **Authorized official:** JERRY JACOBS M.D. (SOLE OWNER)
- **Authorized official phone:** (818) 888-7815

## Contact information

- **Practice address:** 128 S. MONTEBELLO BLVD., MONTEBELLO, CA 90640
- **Practice address phone:** (818) 888-7815
- **Mailing address:** PO BOX 7001, TARZANA, CA 91357
- **Mailing address phone:** (818) 888-7815
- **Mailing address fax:** (818) 715-1722

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | G52993 | CA | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | G52993 | CA | Yes |

## Other

- **Enumeration date:** 10/06/2006
- **Last updated:** 09/11/2025