Individual
TIMOTHY J JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 S RAYMOND AVE, PASADENA, CA 91105-3229
(626) 795-8051
(626) 795-0356
Mailing address
PO BOX 90730, PASADENA, CA 91109-0730
(626) 795-8051
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A102360
CA
Other
Enumeration date
10/08/2008
Last updated
10/04/2018
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