Individual
DR. MARK EDWIN JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1260 N DUTTON AVE STE 160, SANTA ROSA, CA 95401-7139
(707) 524-2442
(707) 524-2438
Mailing address
1260 N DUTTON AVE STE 160, SANTA ROSA, CA 95401-7139
(707) 524-2442
(707) 524-2438
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A436310
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00S436310
—
CA
Enumeration date
07/13/2006
Last updated
12/22/2021
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