Individual
JACOB BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3260 SEEBA LN, GARBERVILLE, CA 95542-9742
(707) 298-4176
Mailing address
PO BOX 395, MIRANDA, CA 95553-0395
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
B3385616
CA
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
CA
Other
Enumeration date
08/21/2025
Last updated
10/05/2025
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