TARA JACKSON GLENN

LA JOLLA, CA
NPI1992060974
Former NameTARA CHRISTINE JACKSON
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy2080N0001X Pediatrics, Neonatal-Perinatal Medicine
(Licence: CA  A170207)
Additional Taxonomies208000000X Pediatrics
(Licence: CA  A170207)
208000000X Pediatrics
(Licence: OH  35-126046)
Enumeration Date2012-07-06
Last Update Date2021-04-08
Business Address
TARA JACKSON GLENN MD
9300 CAMPUS POINT DR
LA JOLLA, CA 92037-1300
Phone number: 858-249-5800
Mailing Address
TARA JACKSON GLENN MD
3020 CHILDRENS WAY # MC5003
SAN DIEGO, CA 92123-4223
Phone number: 858-309-6300