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Organization

IV-PROFUSION

Active
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Organization

IV-PROFUSION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RONALD IRVING JACOBY MD (MEDICAL DIRECTOR)
(626) 260-3115
Entity
Organization

Contact information

Practice address
655 W ARROW HWY UNIT 38, SAN DIMAS, CA 91773-2936
(626) 260-3115
(844) 892-1555
Mailing address
633 W ROUTE 66 APT 202, GLENDORA, CA 91740-4143
(626) 260-3115

Taxonomy

Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary

Other

Enumeration date
09/16/2024
Last updated
09/16/2024
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