Jacobs, Ivan Richard

Jacobs, Ivan Richard is an individual health care provider with primary practice located at 8501 Wilshire Blvd Ste 316, Beverly Hills CA 90211-3128. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Jacobs, Ivan Richard can be contacted via phone (310) 652-2255.

Contact Information

Primary practice address
8501 Wilshire Blvd Ste 316 Beverly Hills CA 90211-3128
Phone: (310) 652-2255
Fax: (310) 652-2039
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X C27493 California

Profile Details

NPI number 1093719858
LBN Legal business name Jacobs, Ivan Richard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2005
Last updated Sep 25th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093719858 NPPES
California Other 00C274930 BLUE SHIELD
California MEDICAID 00C274930 BLUE SHIELD

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