Organization
ANITA C. JACKSON, M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANITA C JACKSON MD (PRESIDENT)
(951) 694-4688
Entity
Organization
Contact information
Practice address
31720 HIGHWAY 79 SOUTH, SUITE 203, TEMECULA, CA 92592
(951) 694-4688
(951) 694-4760
Mailing address
31720 HIGHWAY 79 SOUTH, SUITE 203, TEMECULA, CA 92592
(951) 694-4688
(951) 694-4760
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
A053675
CA
Other
Enumeration date
09/20/2006
Last updated
08/22/2020
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