ROBERT B JACOB DDS INC NPI 1992175699

NPI Information

NPI: 1992175699
Provider Name: ROBERT B JACOB, DDS, INC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
4617 RUFFNER ST STE 200
SAN DIEGO, CA
ZIP 92111
Phone: (858) 268-1006
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ROBERT B JACOB, DDS, INC is a dental clinic center in San Diego, CA. ROBERT B JACOB, DDS, INC NPI is 1992175699. The provider is registered as an organization entity type.

The provider's business location address is:

4617 RUFFNER ST STE 200
SAN DIEGO, CA
ZIP 92111-284
Phone: (858) 268-1006
Fax: (858) 268-5097

The provider's authorized official is Robert B Jacob .
The authorized official title is President and has the following contact phone number (858) 268-1006.

The enumeration date for this NPI number is 10/7/2015 and was last updated on 10/7/2015.

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	261QD0000X	Clinic/Center	Dental	B25912	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	B25912-01	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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