Organization
CALIFORNIA GASTROENTEROLOGY, A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL F. JACOBY M.D. (PRESIDENT)
(530) 672-2701
Entity
Organization
Contact information
Practice address
3108 PONTE MORINO DR, SUITE 230, CAMERON PARK, CA 95682-8278
(530) 672-2701
Mailing address
3108 PONTE MORINO DR, SUITE 230, CAMERON PARK, CA 95682-8278
(530) 672-2701
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Enumeration date
04/03/2008
Last updated
04/03/2008
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