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1003055401
JACKSON W PENRY
MISSION VIEJO, CA
NPI
1003055401
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2085R0202X Radiology, Diagnostic Radiology
(Licence: CA A114302)
Enumeration Date
2009-02-10
Last Update Date
2014-07-29
Business Address
-- JACKSON W PENRY MD
27700 MEDICAL CENTER ROAD-RADIOLOGY DEPARTMENT
MISSION VIEJO, CA 92691-6426
Phone number: 949-364-7744
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Mailing Address
-- JACKSON W PENRY MD
DEPT LA 21789
PASADENA, CA 91185-1789
Phone number: 949-263-8620
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