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Mr. Jacob T. Dines, DO
Military Health Care Provider in Ridgecrest, California
NPI 1003380288

Jacob T. Dines is a Military Health Care Provider based in Ridgecrest, CA. Jacob T. Dines practices in Ridgecrest, CA and has the professional credentials of DO. The NPI Number for Jacob T. Dines is 1003380288 and holds a License No. (California).

The current practice location address for Jacob T. Dines is 1 Administration Cir # Ms 1015, Ridgecrest, CA and can be reached out via phone at 760-939-8063.

Location: 1 Administration Cir # Ms 1015, Ridgecrest, CA, 93555-6104
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1003380288
Provider Name
Jacob T. Dines
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
1 Administration Cir # Ms 1015, Ridgecrest, CA, 93555-6104
Phone Number
760-939-8063
Fax Number
Provider Enumeration Date
01/22/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1 Administration Cir # Ms 1015
City
Ridgecrest
State
California
Zip
93555-6104
Phone Number
760-939-8063
Fax Number
person
Provider Business Mailing Address Details
Address
1 Administration Cir # Ms 1015
City
Ridgecrest
State
California
Zip
93555-6104
Phone Number
760-939-8063
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
OS17059 (Florida)
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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