Organization
STANLEY JACOBS, M.D. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVELYN MITCHELL (OFFICE MANAGER)
(707) 473-0220
Entity
Organization
Contact information
Practice address
145 FOSS CREEK CIR, HEALDSBURG, CA 95448-4288
(707) 473-0220
(707) 473-0990
Mailing address
PO BOX 6671, SANTA ROSA, CA 95406-0671
(707) 473-0220
(707) 623-9409
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
09/18/2014
Last updated
09/18/2014
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