Individual
SHARON JACOB-SOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3860 CALLE FORTUNADA, STE #210, SAN DIEGO, CA 92123-4802
(858) 309-6303
(858) 309-6301
Mailing address
3860 CALLE FORTUNADA, STE #210, SAN DIEGO, CA 92123-4802
(858) 309-6303
(858) 309-6301
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A100287
CA
207N00000X
Dermatology Physician
ME89945
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2704986-00
—
FL
Enumeration date
06/30/2006
Last updated
10/25/2011
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