Individual
JACOB BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(858) 657-7000
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
(800) 926-8273
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A141518
CA
207RP1001X
Pulmonary Disease Physician
Primary
A141518
CA
208000000X
Pediatrics Physician
A141518
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
U0410385
—
CA
Enumeration date
04/01/2015
Last updated
04/30/2024
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