Individual
MARK MATTHEW JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3553 WHIPPLE ROAD, SAN LEANDRO, CA 94587-1507
(510) 454-1000
(415) 499-4213
Mailing address
3553 WHIPPLE ROAD, UNION CITY, CA 94587-1507
(510) 454-1000
(415) 499-4213
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
G45317
CA
207VM0101X
Maternal & Fetal Medicine Physician
G45317
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G453170
—
CA
01
—
G45317
CA STATE LICENSE NUMBER
CA
Enumeration date
03/27/2006
Last updated
10/02/2015
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