Provider Demographics
NPI:1609908276
Name:JACOBI, NEAL H (MD)
Entity Type:Individual
Prefix:
First Name:NEAL
Middle Name:H
Last Name:JACOBI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1425 FRUITDALE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-3234
Mailing Address - Country:US
Mailing Address - Phone:408-275-1010
Mailing Address - Fax:408-275-1066
Practice Address - Street 1:1425 FRUITDALE AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-3234
Practice Address - Country:US
Practice Address - Phone:408-275-1010
Practice Address - Fax:408-275-1066
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG428972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G428971Medicare PIN
CAA89768Medicare UPIN