Individual
MR. JACOB DANIEL NEWSOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1131 AVENIDA FRONTERA, OCEANSIDE, CA 92057-7732
(609) 231-8485
Mailing address
1131 AVENIDA FRONTERA, OCEANSIDE, CA 92057-7732
(609) 231-8485
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
VA
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
01/28/2018
Last updated
09/18/2022
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