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Individual
SUMA JACOB
Active
Individual
SUMA JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
C199229
CA
2084P0804X
Child & Adolescent Psychiatry Physician
C199229
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932269396
—
MN
01
—
260003800
MEDICARE PTAN
MN
Enumeration date
12/08/2006
Last updated
01/24/2025
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