Individual
DANIEL JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
390 N LOOP ROAD, FORT IRWIN, CA 92310
(760) 383-5507
Mailing address
390 N LOOP ROAD, FORT IRWIN, CA 92310
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DX6281
MD
Other
Enumeration date
08/05/2025
Last updated
08/05/2025
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