Jacobson, Mark David

Jacobson, Mark David is an individual health care provider with primary practice located at 5555 Reservoir Dr Ste 104 , San Diego CA 92120-5198. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hand Surgery, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Jacobson, Mark David can be contacted via phone (619) 286-6930.

Contact Information

Primary practice address
5555 Reservoir Dr Ste 104 San Diego CA 92120-5198
Phone: (619) 286-6930
Fax: (619) 286-9438
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hand Surgery 207XS0106X G71151 California
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X G71151 California

Profile Details

NPI number 1760551915
LBN Legal business name Jacobson, Mark David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 6th, 2006
Last updated Dec 6th, 2018 - about 6 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 1760551915 NPPES
California MEDICAID 00G711510
California Other 990010759

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