Individual
TIMOTHY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
34800 BOB WILSON DR, FLEET LIAISON BLDG 2, SAN DIEGO, CA 92134-1098
(619) 532-9512
(619) 532-6404
Mailing address
34800 BOB WILSON DR, FLEET LIAISON BLDG 2, SAN DIEGO, CA 92134-1098
(619) 532-9512
(619) 532-6404
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
—
—
Other
Enumeration date
12/15/2006
Last updated
07/08/2007
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