Individual
JACOB R LIPOVAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Credential
MEDICAL STUDENT
Contact information
Practice address
4301 X ST, SACRAMENTO, CA 95817-2214
(916) 734-2011
Mailing address
8804 SAWTELLE WAY APT B, SACRAMENTO, CA 95826-2114
(636) 399-9098
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/07/2023
Last updated
08/26/2024
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