Individual
DR. JACK STUART MADOWITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8851 CENTER DR STE 312, LA MESA, CA 91942-3050
(619) 667-0708
(619) 667-5343
Mailing address
8851 CENTER DR STE 312, LA MESA, CA 91942-3050
(619) 667-0708
(619) 667-5343
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G40881
CA
Other
Enumeration date
07/17/2006
Last updated
08/17/2007
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