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Individual

DR. JACKIE A BOLDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6066 CIVIC TERRACE AVE, NEWARK, CA 94560
(510) 505-1600
(510) 494-7240
Mailing address
PO BOX 10285, OAKLAND, CA 94610

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
G57227
CA

Other

Enumeration date
01/26/2007
Last updated
07/08/2007
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