Basic Information
| Provider Information | |||||||||
| NPI: | 1255484820 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAUBER | ||||||||
| FirstName: | JACOB | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9033 WILSHIRE BLVD | ||||||||
| Address2: | SUITE 401 | ||||||||
| City: | BEVERLY HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902111837 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102731003 | ||||||||
| FaxNumber: | 3102732551 | ||||||||
| Practice Location | |||||||||
| Address1: | 9033 WILSHIRE BLVD | ||||||||
| Address2: | SUITE 401 | ||||||||
| City: | BEVERLY HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902111837 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102731003 | ||||||||
| FaxNumber: | 3102732551 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/18/2007 | ||||||||
| LastUpdateDate: | 03/13/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | G41526 | CA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.