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Jacob Milton Murdock IV
Student in an Organized Health Care Education/Training Program in Lakeside, California
NPI 1124555461

Jacob Milton Murdock IV is a Student in an Organized Health Care Education/Training Program based in Encinitas, CA. Jacob Milton Murdock IV practices in Lakeside, CA. The NPI Number for Jacob Milton Murdock IV is 1124555461 and holds a License No. (California).

The current practice location address for Jacob Milton Murdock IV is 12064 Woodside Ave Suite 105, Lakeside, CA and can be reached out via phone at 619-436-4263.

Location: 12064 Woodside Ave Suite 105, Lakeside, CA, 92024
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1124555461
Provider Name
Jacob Milton Murdock IV
Credential
Provider Entity Type
Individual
Gender
Male
Address
12064 Woodside Ave Suite 105, Lakeside, CA, 92024
Phone Number
619-436-4263
Fax Number
Provider Enumeration Date
05/17/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
12064 Woodside Ave Suite 105
City
Lakeside
State
California
Zip
92040
Phone Number
619-436-4263
Fax Number
person
Provider Business Mailing Address Details
Address
12064 Woodside Ave Suite 105
City
Lakeside
State
California
Zip
92040
Phone Number
619-436-4263
Fax Number
person
Provider's Taxonomy Details 1
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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