Individual
JEDIDIAH ANDREW JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
2140 W CHAPMAN AVE STE 103, ORANGE, CA 92868-2331
(714) 602-6436
Mailing address
2140 W CHAPMAN AVE STE 103, ORANGE, CA 92868-2331
(714) 602-6436
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
CPO03265
CA
224P00000X
Prosthetist
CPO03265
CA
Other
Enumeration date
12/27/2017
Last updated
03/17/2018
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