Provider Demographics
NPI:1609519289
Name:JACOB, LAYA (MD)
Entity Type:Individual
Prefix:DR
First Name:LAYA
Middle Name:
Last Name:JACOB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 461
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90508-0461
Mailing Address - Country:US
Mailing Address - Phone:424-306-8070
Mailing Address - Fax:310-533-1841
Practice Address - Street 1:HARBOR UCLA MEDICAL CENTER
Practice Address - Street 2:1000 WEST CARSON ST
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90508-0461
Practice Address - Country:US
Practice Address - Phone:424-306-8070
Practice Address - Fax:310-533-1841
Is Sole Proprietor?:No
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program