Gary J Jacobson OD

NPI 1073680815 - Optometrist - 152W00000X

NPI Details
NPI 1073680815
Gender Male
Enumeration Date 11/29/2006
Last Updated 09/23/2008
Entity Type Individual
Active Over 10 years ago
Practice Location
9961 SIERRA AVE
FONTANA CA, 92335-6720, US
Phone (909) 427-3910
Fax
Business Location
9961 SIERRA AVE
FONTANA CA, 92335-6720, US
Phone (909) 427-3910
Fax
Toxanomy
Taxonomy Code 152W00000X
License State California
License Number OPT6467TPA
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According to our database, Gary J Jacobson OD NPI is 1073680815, taxonomy code is 152W00000X and license number is OPT6467TPA, license state is located at California. Gary J Jacobson OD physically located at 9961 Sierra Ave, Fontana CA, 92335-6720. NPI Number Gary J Jacobson OD has the Individual type.

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1073680815 NPI number is provided on an as is basis without warranty of any kind. 1073680815 is maintained by the National Plan & Provider Enumeration System. The contents of Gary J Jacobson OD are for informational purposes only.