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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