Individual
MR. JACOB SAMUEL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2755 HERNDON, CLOVIS, CA 93612
(559) 324-4066
(559) 324-4000
Mailing address
PO BOX 45123, SAN FRANCISCO, CA 94145
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A51688
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A516880
BS OF CA
CA
05
—
00A516880
—
CA
Enumeration date
05/15/2006
Last updated
07/08/2007
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