Individual
JERRY JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
128 S. MONTEBELLO BLVD., MONTEBELLO, CA 90640
(818) 888-7815
Mailing address
PO BOX 7001, TARZANA, CA 91357
(818) 888-7815
(818) 715-1722
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
G52993
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
G52993
CA
Other
Enumeration date
10/03/2006
Last updated
09/11/2025
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