NPI 1003380288

Jacob T. Dines, DO

Practitioner Military Health Care Provider Ridgecrest, CA

Practice location

Address: 1 Administration Cir # Ms 1015, Ridgecrest, CA 93555-6104
Phone: (760) 939-8063

Registered specialties (2)

Military Health Care Provider Primary

Other Service Providers Taxonomy 171000000X Licence OS17059 (FL)

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Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1003380288
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Jan 2019
Record last updated: 21 Jul 2021

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.