Jacobs, Mark Matthew

Jacobs, Mark Matthew is an individual health care provider with primary practice located at 3553 Whipple Road , San Leandro CA 94587-1507. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Maternal & Fetal Medicine. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is his primary health care specialty. Jacobs, Mark Matthew can be contacted via phone (510) 454-1000.

Contact Information

Primary practice address
3553 Whipple Road San Leandro CA 94587-1507
Phone: (510) 454-1000
Fax: (415) 499-4213
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X G45317 California
Allopathic & Osteopathic Physicians / Maternal & Fetal Medicine 207VM0101X G45317 California

Profile Details

NPI number 1679533186
LBN Legal business name Jacobs, Mark Matthew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2006
Last updated Oct 2nd, 2015 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679533186 NPPES
California Other G45317 CA STATE LICENSE NUMBER
California MEDICAID 00G453170 CA STATE LICENSE NUMBER

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