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Individual

JACOB EAPEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
751 S BASCOM AVE, PEDIATRICS DEPARTMENT, SAN JOSE, CA 95128-2604
(408) 885-5000
Mailing address
43525 GALLEGOS AVE, FREMONT, CA 94539-5755
(510) 226-8778

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A521082
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A510820
CA
Enumeration date
04/05/2006
Last updated
05/07/2013
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