Provider Demographics
NPI:1356769848
Name:JACOBSON, JOSHUA YOUSHA (MD)
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:YOUSHA
Last Name:JACOBSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:30200 AGOURA RD STE 150
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-5427
Mailing Address - Country:US
Mailing Address - Phone:310-400-6432
Mailing Address - Fax:330-481-5023
Practice Address - Street 1:433 N BEDFORD DR # 770
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4302
Practice Address - Country:US
Practice Address - Phone:424-465-3800
Practice Address - Fax:330-481-5023
Is Sole Proprietor?:No
Enumeration Date:2014-04-01
Last Update Date:2023-09-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA167657208200000X, 208200000X
NY302209390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program