Organization
J. BRUCE JACOBS, M.D., INC.
Active
Other names
CALIFORNIA RADIOLOGY .COM
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEXANDER USMANOV M.D. (PRESIDENT)
(818) 841-8880
Entity
Organization
Contact information
Practice address
1821 W OLIVE AVE, BURBANK, CA 91506-2435
(818) 841-8880
(818) 841-8884
Mailing address
1821 W OLIVE AVE, BURBANK, CA 91506-2435
(818) 841-8880
(818) 841-8884
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A21604
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316205644
—
CA
Enumeration date
04/24/2012
Last updated
01/27/2014
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