Delarosa, Jacob
Delarosa, Jacob is an sole proprietor health care provider with primary practice located at 651 Memorial Dr , Pocatello ID 83201-4071. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Delarosa, Jacob can be contacted via phone (208) 239-1000.Contact Information
Primary practice address
651 Memorial Dr
Pocatello ID 83201-4071
Phone: (208) 239-1000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | M9019 | Idaho |
Profile Details
| NPI number | 1083759880 |
|---|---|
| LBN Legal business name | Delarosa, Jacob |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 20th, 2007 |
| Last updated | Mar 19th, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083759880 | NPPES |
| Idaho | Other | M9019 | STATE |
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