DESIDERIO C JACOB

COMPTON, CA
NPI1245456417
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy305R00000X Preferred Provider Organization
(Licence: CA  A23679)
Enumeration Date2007-04-17
Last Update Date2007-07-09
Business Address
Dr. DESIDERIO C JACOB M.D.
2140 S SANTA FE AVE
COMPTON, CA 90221-5311
Phone number: 310-631-1107
Mailing Address
Dr. DESIDERIO C JACOB M.D.
960 PASEO LA CRESTA
PALOS VERDES ESTATES, CA 90274-2053
Phone number: 310-373-3868
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