Organization
RANDY JACOBS DERMATOLOGY INC.
Active
Organization
RANDY JACOBS DERMATOLOGY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMY S BOLON (OFFICE MANAGER)
(951) 672-7673
Entity
Organization
Contact information
Practice address
27640 ENCANTO DR, # B, SUN CITY, CA 92586-3304
(951) 672-7673
(951) 672-1197
Mailing address
23905 CLINTON KEITH RD, 114, WILDOMAR, CA 92595-7899
(951) 672-7673
(951) 672-1197
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A049395
CA
Other
Enumeration date
09/20/2006
Last updated
03/12/2008
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