Jackson, James M

Jackson, James M is an individual health care provider with primary practice located at 3771 Katella Ave Suite 310, Los Alamitos CA 90720. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Jackson, James M can be contacted via phone (562) 430-3561.

Contact Information

Primary practice address
3771 Katella Ave Suite 310 Los Alamitos CA 90720
Phone: (562) 430-3561
Fax: (562) 431-8882
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X G74843 California

Profile Details

NPI number 1619060134
LBN Legal business name Jackson, James M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 2nd, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619060134 NPPES
California MEDICAID 00G748430
California Other G74843

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