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Jacob Lake, IDC
NPI 1871355974 · Independent Duty Corpsman · San Diego, CA
Jacob Lake, IDC is a Independent Duty Corpsman provider in San Diego, CA (NPI 1871355974).
Provider details
- NPI number
- 1871355974
- Entity type
- Individual
- Primary specialty
- Independent Duty CorpsmanOther Service Providers
- Credential
- IDC
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Other Service Providers
Profile Score
Established profile(51/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
34101 Farenholt Ave Bldg 14
San Diego, CA 92134-7000
Phone: (757) 376-3269
Approximate (ZIP-level) locationGet directions
Mailing address
137 Carnation Ave
Imperial Beach, CA 91932-1007
Registry dates
- Enumerated
- 2024-01-25
- Last updated
- 2024-01-25
- Certified
- 2024-01-17
Frequently asked questions
- What is Jacob Lake's NPI number?
- Jacob Lake's National Provider Identifier (NPI) is 1871355974, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jacob Lake's specialty?
- Jacob Lake is listed in the NPPES registry with a primary specialty of Independent Duty Corpsman (Other Service Providers).
- Where is Jacob Lake located?
- Jacob Lake's practice location on file with NPPES is 34101 Farenholt Ave Bldg 14, San Diego, CA 92134-7000.
- What is Jacob Lake's phone number?
- The practice phone number listed in the NPPES registry for Jacob Lake is (757) 376-3269.
- Is Jacob Lake's NPI active?
- Yes — Jacob Lake's NPI (1871355974) is active in the NPPES registry as of the last update on 2024-01-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.