SHARON JACOB-SOO (NPI# 1053349688) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053349688 |
| Entity Type | Individual |
| Full Name | SHARON JACOB-SOO |
| Credential | MD |
| Practice Address |
3860 Calle Fortunada Ste #210 San Diego CA 92123-4802 |
| Practice Telephone | 8583096303 |
| Practice Fax Number | 8583096301 |
| Mailing Telephone | 8583096303 |
| Mailing Fax Number | 8583096301 |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2011-10-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | A100287 | CA | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | ME89945 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 2704986-00 | 05 |
| Street Address |
3860 CALLE FORTUNADA STE #210 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92123-4802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144210725 | Sharon Strong Kim | Pediatrics | 3860 Calle Fortunada, Ste 200, San Diego, CA 92123-4800 | 2005-10-25 |
| 1487916904 | Melissa R Behnke | Pediatrics | 3860 Calle Fortunada, 200, San Diego, CA 92123-4800 | 2012-06-11 |
| 1720271513 | Cssd II A Medical Group Inc | Health Maintenance Organization | 3860 Calle Fortunada, Suite 210, San Diego, CA 92123-4800 | 2007-08-24 |
| 1427259597 | Ucsd Pediatric Associates | Pediatrics | 3860 Calle Fortunada, Ste 200, San Diego, CA 92123-4800 | 2007-05-29 |
| 1073638680 | Colette L. Grant | Pediatrics | 3860 Calle Fortunada, Ste 200, San Diego, CA 92123-4800 | 2007-03-20 |
| 1659419505 | Children's Physicians Medical Group | Health Maintenance Organization | 3860 Calle Fortunada, Suite 210, San Diego, CA 92123-4800 | 2007-02-02 |
| 1336298074 | Deborah Mills | Nurse Practitioner | 3860 Calle Fortunada, Ste 200, San Diego, CA 92123-4800 | 2007-01-10 |
| 1003965757 | Diane Strader | Nurse Practitioner | 3860 Calle Fortunada, Ste 200, San Diego, CA 92123-4800 | 2007-01-10 |
| 1063561710 | Dory Clark | Nurse Practitioner | 3860 Calle Fortunada, Ste 200, San Diego, CA 92123-4800 | 2007-01-10 |
| 1588713143 | Ghazala Mobin | Physician Assistant | 3860 Calle Fortunada, Ste 200, San Diego, CA 92123-4800 | 2007-01-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087326 | Corina Lozano Manzo | Registered Nurse | 7436 Mission Center Road, San Diego, CA 92123 | 2020-09-10 |
| 1831703537 | Shannon Leigh Doolittle | Audiologist | 3020 Children's Way Mc5010, San Diego, CA 92123 | 2020-09-01 |
| 1861014359 | Ha Thanh Truong | Pharmacist | Rezcare, 3821 Calle Fortunada, San Diego, CA 92123 | 2020-05-07 |
| 1023667136 | Brittany Meyer | Physical Therapist | 3020 Children's Waymc5068, San Diego, CA 92123 | 2019-09-11 |
| 1598313272 | Ryan Edward Shaw | Marriage & Family Therapist | 8910 Clairmont Mesa Blvd, San Diego, CA 92123 | 2019-08-27 |
| 1528611910 | Tanisha C Fulcher | Marriage & Family Therapist | 8825 Aero Dr., Ste 315, San Diago, CA 92123 | 2019-07-24 |
| 1245795665 | Robin James Pekin | Marriage & Family Therapist | 4450 Kearny Villa Rd, #116, San Diego, CA 92123 | 2019-02-11 |
| 1174093728 | Karen Vences | Counselor | 8755 Aero Dr Suite 230, San Diego, CA 92123 | 2018-11-27 |
| 1255808465 | Natasha Herrera | Counselor | 2801 Meadow Lark Dr, San Diego, San Diego, CA 92123 | 2018-10-25 |
| 1407321987 | Maneka Elikewela | Behavior Technician | 3934 Murphy Canyon Rd, Ste B202, San Diego, CA 92123 | 2018-10-10 |
| Find all providers in zip 92123 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497399141 | Dermatology Specialists Inc | Dermatology | 4765 Carmel Mountain Rd Ste 201, San Diego, CA 92130-6657 | 2019-11-05 |
| 1306405998 | Mismo Dermatology Group Apc | Dermatology | 8898 Navajo Rd Ste C-349, San Diego, CA 92119-2141 | 2019-06-07 |
| 1609361740 | Seaver Soon Md Inc | Dermatology | 2044 W California St, San Diego, CA 92110-2121 | 2018-06-29 |
| 1700240249 | Alexandra Edelman | Dermatology | 3965 5th Ave Ste 200, San Diego, CA 92103-3107 | 2016-04-11 |
| 1033572391 | Lauren Metterle | Dermatology | 3020 Childrens Way # 5092, San Diego, CA 92123-4223 | 2016-04-03 |
| 1225493323 | Jeanette Jacknin | Dermatology | 12634 Carmel Country Rd, Suite 126, San Diego, CA 92130-3197 | 2015-12-16 |
| 1417330432 | Eugene Tachuk | Dermatology | 3740 Rosecrans St Ste C, San Diego, CA 92110-3126 | 2015-07-08 |
| 1508203563 | Monica Boen | Dermatology | 9339 Genesee Ave Ste 350, San Diego, CA 92121-2150 | 2013-05-31 |
| 1619311164 | David Otto Schairer | Dermatology | 8010 Frost St Ste 602, San Diego, CA 92123 | 2013-04-25 |
| 1295037760 | Susan Ann Kincaid | Dermatology | 1951 4th Ave Ste 202, San Diego, CA 92101-2374 | 2010-12-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.