Organization
JACK F JACOUB MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK F JACOUB M.D. (PRESIDENT AND CEO)
(714) 756-0731
Entity
Organization
Contact information
Practice address
18111 BROOKHURST ST STE 6100, FOUNTAIN VALLEY, CA 92708-6728
(714) 378-7330
(714) 377-0003
Mailing address
18111 BROOKHURST ST STE 6100, FOUNTAIN VALLEY, CA 92708-6728
(714) 378-7330
(714) 377-0003
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
A79623
CA
Other
Enumeration date
01/21/2010
Last updated
09/30/2020
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