Individual
JACKLEN JAMEL KHURI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21641 CANADA RD APT 19E, LAKE FOREST, CA 92630-2774
(909) 380-4419
Mailing address
21641 CANADA RD APT 19E, LAKE FOREST, CA 92630-2774
(909) 380-4419
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
671397
CA
Other
Enumeration date
05/21/2013
Last updated
05/21/2013
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