Individual
DR. JACKLYN C MA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8700 BEVERLY BLVD # 8211, WEST HOLLYWOOD, CA 90048-1804
(310) 423-5841
Mailing address
8700 BEVERLY BLVD # 8211, WEST HOLLYWOOD, CA 90048-1804
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
A125181
CA
207LP3000X
Pediatric Anesthesiology Physician
Primary
A125181
CA
Other
Enumeration date
05/04/2011
Last updated
12/07/2021
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