Individual
JEREMY ROBERT THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2185 CITRACADO PKWY, ESCONDIDO, CA 92029-4159
(442) 281-5000
Mailing address
445 LOS ARBOLITOS BLVD, OCEANSIDE, CA 92058-1529
(808) 208-2057
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
95118366
CA
Other
Enumeration date
06/23/2025
Last updated
06/23/2025
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