| Anita C. Jackson, M.D., Inc | |
|
31720 Highway 79 South Suite 203 Temecula CA 92592 | |
| (951) 694-4688 | |
| (951) 694-4760 |
| Full Name | Anita C. Jackson, M.D., Inc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 31720 Highway 79 South, Temecula, California |
| Authorized Official Name and Position | Anita C Jackson (PRESIDENT) |
| Authorized Official Contact | 9516944688 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Anita C. Jackson, M.D., Inc 31720 Highway 79 South Suite 203 Temecula CA 92592 Ph: (951) 694-4688 | Anita C. Jackson, M.D., Inc 31720 Highway 79 South Suite 203 Temecula CA 92592 Ph: (951) 694-4688 |
| NPI Number | 1326145756 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326145756 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A053675 (California) | Primary |
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