Individual
DR. RICHARD JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
26800 CROWN VALLEY PKWY, SUITE 250, MISSION VIEJO, CA 92691-6384
(949) 364-3570
(949) 364-3430
Mailing address
26522 LA ALAMEDA, SUITE 120, MISSION VIEJO, CA 92691-6330
(949) 282-1671
(949) 367-0518
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G22936
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G229360
—
CA
Enumeration date
12/26/2005
Last updated
01/23/2013
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