Jackson, Michelle

Jackson, Michelle is an individual health care provider with primary practice located at 3613 Vista Way , Oceanside CA 92056-4522. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatopathology, Allopathic & Osteopathic Physicians / Procedural Dermatology. Allopathic & Osteopathic Physicians / Procedural Dermatology is her primary health care specialty. Jackson, Michelle can be contacted via phone (760) 758-5340.

Contact Information

Primary practice address
3613 Vista Way Oceanside CA 92056-4522
Phone: (760) 758-5340
Fax: (760) 758-5502
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatopathology 207ND0900X A102012 California
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X A102012 California

Profile Details

NPI number 1184846529
LBN Legal business name Jackson, Michelle
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2007
Last updated Aug 29th, 2012 - about 13 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 1184846529 NPPES
California Other GG162Z PTAN

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