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1174080030
BRIAN JEFFRY JACKSON
NEWPORT BEACH, CA
NPI
1174080030
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA NP95010531)
Enumeration Date
2019-02-27
Last Update Date
2019-10-03
Business Address
BRIAN JEFFRY JACKSON NP
2075 SAN JOAQUIN HILLS RD
NEWPORT BEACH, CA 92660-6505
Phone number: 949-760-9222
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Mailing Address
BRIAN JEFFRY JACKSON NP
3801 MARQUETTE PL APT 4C
SAN DIEGO, CA 92106-1059
Phone number: 541-550-6572
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