Individual
DR. BLAINE KENTON JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
773 ACADEMY DR, SOLANA BEACH, CA 92075
(858) 259-9708
(858) 259-9689
Mailing address
773 ACADEMY DR, SOLANA BEACH, CA 92075-2031
(858) 259-9708
(858) 259-9689
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A67288
CA
Other
Enumeration date
08/31/2006
Last updated
05/23/2018
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