MARK MATTHEW JACOBS M.D. NPI 1679533186

NPI Information

NPI: 1679533186
Provider Name: MARK MATTHEW JACOBS, M.D.
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
3553 WHIPPLE ROAD
SAN LEANDRO, CA
ZIP 94587
Phone: (510) 454-1000
Get Directions

Mark Matthew Jacobs, M.D. is an obstetrics gynecology in San Leandro, CA. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. Mark Matthew Jacobs, M.D. NPI is 1679533186. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3553 WHIPPLE ROAD
SAN LEANDRO, CA
ZIP 94587-507
Phone: (510) 454-1000
Fax: (415) 499-4213

The NPI 1679533186 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/27/2006 and was last updated on 10/2/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207VM0101X	Obstetrics & Gynecology	Maternal & Fetal Medicine	G45317	CALIFORNIA	No
2	207V00000X	Obstetrics & Gynecology		G45317	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	G45317	OTHER	CALIFORNIA	CA STATE LICENSE NUMBER
2	A49983	MEDICARE UPIN	CALIFORNIA
3	00G453170	MEDICARE PIN	CALIFORNIA
4	00G453170	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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