Provider Demographics
NPI:1386031730
Name:HABEEB, JACOB YOUSIF (DO)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:YOUSIF
Last Name:HABEEB
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 CHOLLA RD
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-6613
Mailing Address - Country:US
Mailing Address - Phone:619-339-0327
Mailing Address - Fax:
Practice Address - Street 1:709 CHOLLA RD
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-6613
Practice Address - Country:US
Practice Address - Phone:619-339-0327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-23
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program