Jacob Yochanan Stibelman
in Beverly Hills, CA. Individual provider (NPI-1).
NPI number1134879885
StatusActive
Last updated in NPPESJun 26, 2025
Details
- NPI
- 1134879885
- Entity type
- Individual (NPI-1)
- Name
- Jacob Yochanan Stibelman
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 25, 2022
- Certification date
- Jun 26, 2025
- Last updated
- Jun 26, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 213ES0131X | E6121 | CA | Yes | |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
200 N Robertson Blvd Ste 202Beverly Hills, CA 90211-6002
Phone 310-385-6017
Mailing address
4140 W 190th StTorrance, CA 90504-5513
Other practice locations
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