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Contact Information

JACOB DELAROSA, MD
651 MEMORIAL DR
POCATELLO, ID83201-4071
 Phone: 208-239-1000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for JACOB DELAROSA · (Male)

NPI # 1083759880
Status Active
Credentials MD
Entity Individual
Enumeration date 02/20/2007
Last updated 03/19/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • ID License # M9019
  • ID Other M9019 STATE
Hospital affiliation(s)
  • PORTNEUF MEDICAL CENTER - (Acute Care)
    777 HOSPITAL WAY
    POCATELLO, ID 83201
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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