Individual ProviderIrving JacobyEmergency MedicineAllopathic & Osteopathic PhysiciansPractice Address9300 Campus Point Drive, La Jolla, CA 92037(858) 657-7000(888) 486-4380PECOS EnrollmentBased on the most recent information from CMS, provider Irving Jacoby does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1184669178Provider TypeIndividualFull NameJacoby, IrvingCredentialMDGenderMaleSole ProprietorNoEnumeration Date6/17/2006Last Updated2/1/2008Contact InformationPractice LocationPractice Address9300 Campus Point Drive, La Jolla, CA 92037Phone(858) 657-7000FaxUnlisted FaxMailing LocationMailing AddressFile No 54826, Los Angeles, CA 90074-4826Phone(888) 486-4380FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207P00000XPrimaryDescriptionEmergency MedicineAllopathic & Osteopathic PhysiciansLicenseG53173CaliforniaProvider IdentifiersIDDescriptionIssuerIDOOG531730DescriptionMedicaidIssuerUnlistedCalifornia