Individual
CAMILLE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1411 E 31ST ST, DEPARTMENT OF SURGERY, OAKLAND, CA 94602-1018
(510) 437-4965
Mailing address
513 PARNASSUS AVE, S321, DEPARTMENT OF SURGERY, SAN FRANCISCO, CA 94143-2205
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
A156408
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/04/2016
Last updated
10/02/2023
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