Organization
ALJ MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY JACKSON M.D. (PRESIDENT)
(818) 979-4962
Entity
Organization
Contact information
Practice address
10545 BURBANK BLVD, 112, NORTH HOLLYWOOD, CA 91601-2245
(818) 979-4962
(818) 760-1415
Mailing address
10545 BURBANK BLVD, 112, NORTH HOLLYWOOD, CA 91601-2245
(818) 979-4962
(818) 760-1415
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G43207
CA
Other
Enumeration date
01/11/2010
Last updated
01/11/2010
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