Individual
MR. CASEY ROBERT JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
34101 FARENHOLT AVE, SAN DIEGO, CA 92134-7000
(619) 532-6094
Mailing address
34101 FARENHOLT AVE, SAN DIEGO, CA 92134-7000
(619) 532-6094
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
07/24/2009
Last updated
07/24/2009
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