Provider Demographics
NPI:1770656407
Name:JACOBS, TROY ANTHONY (MD, MPH, FAAP)
Entity Type:Individual
Prefix:DR
First Name:TROY
Middle Name:ANTHONY
Last Name:JACOBS
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Gender:M
Credentials:MD, MPH, FAAP
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Mailing Address - Street 1:250 W OCEAN BLVD
Mailing Address - Street 2:UNIT 1603
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-7939
Mailing Address - Country:US
Mailing Address - Phone:562-495-2727
Mailing Address - Fax:
Practice Address - Street 1:1725 W 17TH ST
Practice Address - Street 2:RM. 115M
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-2316
Practice Address - Country:US
Practice Address - Phone:714-834-8411
Practice Address - Fax:714-834-8051
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA85595208000000X
WA37035208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics