Dr. Lisa Jacobs, M.D.
Pediatrics in Fountain Valley, CA. Individual provider (NPI-1).
NPI number1376937367
StatusActive
Last updated in NPPESApr 24, 2019
Details
- NPI
- 1376937367
- Entity type
- Individual (NPI-1)
- Name
- Dr. Lisa Jacobs
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 27, 2015
- Last updated
- Apr 24, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | A149687 | CA | Yes |
Practice location
17100 Euclid Street, PicuFountain Valley, CA 92708
Phone 714-966-7253 · Fax 714-966-3354
Mailing address
757 Westwood Plaza, B711Rrumc
Los Angeles, CA 90095-7419
Phone 310-267-9129
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