Most Relevant Information
Provider Data
| NPI Number: | 1003341249 |
| Provider Name: | JENNIE JACOB |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 53920 |
Most Important Dates
| Enumeration Date: | 04/25/2017 |
| Last Updated: | 04/25/2017 |
Provider Practice Location
555 CASTRO ST
MOUNTAIN VIEW
CA
940412009
Practice Location Phone/Fax
| Phone: | 6509032159 |
| Fax: | 6509032149 |
Provider Mailing Location
555 CASTRO ST
MOUNTAIN VIEW
CA
940412009
Provider Mailing Phone/Fax
| Phone: | 6509032159 |
| Fax: | 6509032149 |