Individual
JACOB LEE BRONSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
954 60TH ST, SUITE 10, OAKLAND, CA 94608-2369
(510) 835-2505
(510) 835-1062
Mailing address
954 60TH ST, SUITE 10, OAKLAND, CA 94608-2369
(510) 835-2505
(510) 835-1062
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0136
—
CA
Enumeration date
04/30/2014
Last updated
04/30/2014
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