JACOB RUSSELL SUBA

SAN BERNARDINO, CA
NPI1407632532
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
Enumeration Date2023-09-05
Last Update Date2023-10-31
Business Address
JACOB RUSSELL SUBA
401 E HIGHLAND AVE STE 351
SAN BERNARDINO, CA 92404-3830
Phone number: 909-475-8611
Mailing Address
JACOB RUSSELL SUBA
PO BOX 9086
REDLANDS, CA 92375-2286
Phone number:
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