Jacobsen, Brent
Jacobsen, Brent is an individual health care provider with primary practice located at 36485 Inland Valley Dr , Wildomar CA 92595-9681. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Jacobsen, Brent can be contacted via phone (909) 677-9773.Contact Information
Primary practice address
36485 Inland Valley Dr
Wildomar CA 92595-9681
Phone: (909) 677-9773
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 20A8142 | California |
Profile Details
| NPI number | 1790890465 |
|---|---|
| LBN Legal business name | Jacobsen, Brent |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 20th, 2006 |
| Last updated | Nov 6th, 2007 - about 18 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 | 1790890465 | NPPES |
| California | MEDICAID | 00AX814200 |
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