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 is legally eligible to order and refer claims for DME and PMD services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 11:51 AM.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