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1407632532
JACOB RUSSELL SUBA
ORANGE, CA
NPI
1407632532
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2023-09-05
Last Update Date
2025-01-16
Business Address
JACOB RUSSELL SUBA
1120 W LA VETA AVE STE 300
ORANGE, CA 92868-4246
Phone number: 714-598-1745
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Mailing Address
JACOB RUSSELL SUBA
2863 SAINT TROPEZ DR
ONTARIO, CA 91761-0398
Phone number: 909-224-0396
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