Individual
RYAN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
31581 CANYON ESTATES DR, LAKE ELSINORE, CA 92532-0424
(951) 244-3500
Mailing address
31581 CANYON ESTATES DR, LAKE ELSINORE, CA 92532-0424
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
52840
CA
Other
Enumeration date
12/08/2015
Last updated
12/03/2021
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