NPI 1003243338

Lawrence Jason Jacobs, SFIDC

Practitioner Independent Duty Corpsman Winchester, CA

Practice location

Address: 34949 Viscaria CT, Winchester, CA 92596-8968
Phone: (260) 740-6714

Registered specialties

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X

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Registry record

NPI: 1003243338
Entity type: Individual
Sex (as registered): Male
NPI issued: 1 Oct 2013
Record last updated: 1 Oct 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.