Individual
JAMES C JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A87878
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A878780
BLUE SHIELD PIN
CA
05
—
00A878780
—
CA
Enumeration date
05/18/2006
Last updated
02/15/2011
Update your record
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