Individual
GAIL TENIKAT JACOBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1036 LAUREL ST, SAN CARLOS, CA 94070
(650) 631-7000
(650) 631-2309
Mailing address
1036 LAUREL ST, SAN CARLOS, CA 94070
(650) 631-7000
(650) 631-2309
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G25405
CA
207NS0135X
Procedural Dermatology Physician
G25405
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
756071264
RAILROAD MEDICARE
CA
Enumeration date
01/20/2006
Last updated
12/17/2008
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