Jacobson, Richard Samuel
Jacobson, Richard Samuel is an sole proprietor health care provider with primary practice located at 10515 Balboa Bl. Suite 250, Granada Hills CA 91344. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics, Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Jacobson, Richard Samuel can be contacted via phone (818) 831-2343.Contact Information
Primary practice address
10515 Balboa Bl. Suite 250
Granada Hills CA 91344
Phone: (818) 831-2343
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics | 2080P0006X | G15588 | California |
| Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities | 2080P0008X | G15588 | California |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | G15588 | California |
Profile Details
| NPI number | 1952443673 |
|---|---|
| LBN Legal business name | Jacobson, Richard Samuel |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 12th, 2007 |
| Last updated | Aug 21st, 2012 - about 13 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 | 1952443673 | NPPES |
| California | MEDICAID | 00G155880 | |
| California | Other | G15588 |
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