Individual
MR. LADALE JACKSON SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5601 W SLAUSON AVE STE 130, CULVER CITY, CA 90230-6576
(310) 910-0406
(310) 928-0981
Mailing address
5601 W SLAUSON AVE STE 130, CULVER CITY, CA 90230-6576
(310) 910-0406
(310) 928-0981
Taxonomy
Speciality
Code
Description
License number
State
175L00000X
Homeopath
Primary
—
—
Other
Enumeration date
12/07/2022
Last updated
12/07/2022
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