Individual
DEAN S JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1212 W 17TH ST, SANTA ANA, CA 92706-3418
(714) 954-0432
Mailing address
1212 W 17TH ST, SANTA ANA, CA 92706-3418
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A91057
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A91057
CA LICENSE
CA
Enumeration date
01/04/2007
Last updated
08/29/2017
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