Individual
CAROL A JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
361 HOSPITAL RD, STE 325, NEWPORT BEACH, CA 92663-3522
(949) 574-7744
(949) 642-3686
Mailing address
361 HOSPITAL RD, STE 325, NEWPORT BEACH, CA 92663-3522
(949) 574-7744
(949) 642-3686
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
G50085
CA
Other
Enumeration date
09/07/2006
Last updated
06/03/2009
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