Individual
EDGAR J JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1011 BALDWIN PARK BLVD, BALDWIN PARK, CA 91706-5806
(626) 851-1011
Mailing address
1011 BALDWIN PARK BLVD, BALDWIN PARK, CA 91706-5806
(626) 851-1011
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10556
CA
Other
Enumeration date
03/21/2007
Last updated
09/23/2008
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