Individual
JACOB MISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
505 PARNASSUS AVE RM M24, SAN FRANCISCO, CA 94143-2204
(415) 353-1529
(415) 353-8499
Mailing address
505 PARNASSUS AVE RM M24, SAN FRANCISCO, CA 94143-2204
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A112338
CA
Other
Enumeration date
11/12/2009
Last updated
04/06/2012
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