DR. MARK EDWIN JACOBSON (NPI# 1770509002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770509002 |
| Entity Type | Individual |
| Full Name | DR. MARK EDWIN JACOBSON |
| Credential | MD |
| Practice Address |
1260 N Dutton Ave Ste 160 Santa Rosa CA 95401-7139 |
| Practice Telephone | 7075242442 |
| Practice Fax Number | 7075242438 |
| Mailing Telephone | 7075242442 |
| Mailing Fax Number | 7075242438 |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | A436310 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00S436310 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841643178 | Mark Jacobson | Counselor | 3170 N Federal Hwy Ste 206e, Lighthouse Point, FL 33064-6720 | 2016-07-21 |
| 1326375437 | Mark S Jacobson | Dentist | 800 Rose St Rm D632, Lexington, KY 40536-0297 | 2009-11-10 |
| 1801935531 | Mark J Jacobson | Social Worker | 1677 Eureka Rd Ste 203, Roseville, CA 95661-3039 | 2007-02-06 |
| 1124059076 | Mark C. Jacobson | Allergy & Immunology | 911 N Elm St Ste 300, Hinsdale, IL 60521-3642 | 2006-07-06 |
| 1306894423 | Mark David Jacobson | Radiology | 769 Highway 466, Lady Lake, FL 32159-6340 | 2006-05-04 |
| 1831178318 | Mark I Jacobson | Pathology | 560 White Plains Rd Fl 6, Tarrytown, NY 10591-5113 | 2006-01-12 |
| 1528480944 | Mark Jacobson | Psychologist | 234 1/2 Washington Ave, Grand Haven, MI 49417-3307 | 2014-01-21 |
| 1053561449 | Mark Edward Jacobson | Orthopaedic Surgery | 370 N 120th Ave, Holland, MI 49424-2196 | 2008-09-23 |
| 1760551915 | Mark David Jacobson | Orthopaedic Surgery | 5555 Reservoir Dr Ste 104, San Diego, CA 92120-5198 | 2006-11-06 |
| 1992898100 | Mark E Jacobson | Optometrist | 3409 Jerome Ave, Bronx, NY 10467-1049 | 2006-10-02 |
| Street Address |
1260 N DUTTON AVE STE 160 |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95401-7139 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972148575 | Megan Elizabeth Jones | In Home Supportive Care | 1239 Eardley Ave, Santa Rosa, CA 95401 | 2019-11-07 |
| 1801447230 | Patty Macisaac | Technician | 3221 Oak Farm Lane, Santa Rosa, CA 95401 | 2019-09-26 |
| 1386114981 | Victoria Maria Guillory | Dental Hygienist | 140 Stony Point Road, Suite A, Santa Rosa, CA 95401 | 2018-11-27 |
| 1811470727 | Chemarin Eve Boyd | Student in an Organized Health Care Education/Training Program | 1260 N Dutton Avenue, 225, Santa Rosa, CA 95401 | 2018-09-07 |
| 1073008181 | Cristavel Camacho | Behavioral Analyst | 1439 Range Ave, #101, Santa Rosa, CA 95401 | 2018-06-30 |
| 1619479102 | Victoria King | Behavior Technician | 1335 N. Dutton Ave., Santa Rosa, CA 95401 | 2018-03-01 |
| 1114436060 | Lacey Lynn Palmer | Counselor | 341 Irwin Lane, Santa Rosa, CA 95401 | 2017-09-22 |
| 1720530587 | Compassionate Homecare Solutions, LLC | In Home Supportive Care | 131 A Stony Circle, Suite 500, Santa Rosa, CA 95401 | 2016-10-27 |
| 1366998981 | William Glenn | Marriage & Family Therapist | 1496 Willowside Road, Santa Rosa, CA 95401 | 2016-09-01 |
| 1790144046 | Advocacy Home Nursing, Inc | Home Health | 1400 North Dutton Avenue, Suite 20, Santa Rosa, CA 95401 | 2016-02-15 |
| Find all providers in zip 95401 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114492162 | Jesse Earl Rathbun Jr. | Ophthalmology | 1920 Grace Dr., Santa Rosa, CA 95404 | 2018-10-05 |
| 1952670796 | Cole Phillip Stephens | Ophthalmology | 4711 Hillsboro Cir, Santa Rosa, CA 95405-8776 | 2011-12-23 |
| 1194024935 | John Lawrence Norris | Ophthalmology | 1415 Olivet Rd, Santa Rosa, CA 95401-3810 | 2011-03-18 |
| 1487785101 | Valerie Sondra Garden | Ophthalmology | 1140 Sonoma Avenue, Building 2a, Santa Rosa, CA 95405-4817 | 2007-03-07 |
| 1346275484 | Sanjay Bansal | Ophthalmology | 3540 Mendocino Avenue, Suite 200, Santa Rosa, CA 95403-3639 | 2006-07-11 |
| 1003851809 | Alice Chiang | Ophthalmology | 1002 Mendocino Ave, Santa Rosa, CA 95401-4330 | 2006-06-17 |
| 1720042617 | David E. Ulmer | Ophthalmology | 990 Sonoma Ave, Ste 10, Santa Rosa, CA 95404-4802 | 2006-04-17 |
| 1972566842 | Brien A. Seeley | Ophthalmology | 4739 Hoen Ave, Santa Rosa, CA 95405-7862 | 2006-04-10 |
| 1326010620 | James E Hunt | Ophthalmology | 1140 Sonoma Ave Ste 2, Santa Rosa, CA 95405-4817 | 2006-02-02 |
| 1114905494 | Kalane Jade Wong | Ophthalmology | 1017 2nd St, Santa Rosa, CA 95404-6608 | 2006-01-05 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95401 |
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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.