Organization
GRETCHEN H. JACOBSON, MD, A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESIREE MORELLI (OFFICE MANAGER)
(805) 983-1700
Entity
Organization
Contact information
Practice address
1700 N ROSE AVE, #250, OXNARD, CA 93030-3790
(805) 983-1700
(805) 983-7144
Mailing address
1700 N ROSE AVE STE 250, OXNARD, CA 93030-7626
(805) 983-1700
(805) 983-7144
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
G63450
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G634500
—
CA
Enumeration date
02/06/2007
Last updated
06/21/2010
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