Individual
MR. BRUCE K JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
520 N PROSPECT AVE, STE. 300, REDONDO BEACH, CA 90277-3041
(310) 372-1156
(310) 372-6504
Mailing address
1360 W 6TH ST, SUITE 200, SAN PEDRO, CA 90732-3514
(310) 547-9922
(310) 547-4673
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A24716
CA
Other
Enumeration date
08/02/2006
Last updated
01/27/2015
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