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Individual

JONATHAN JACOBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3064 TAUSSIG ST, SAN DIEGO, CA 92124
(586) 713-9437
Mailing address
3064 TAUSSIG ST, SAN DIEGO, CA 92124-3637
(586) 713-9437

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary

Other

Enumeration date
09/08/2017
Last updated
07/21/2022
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