Individual
GEORGE ROBERT JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 MEDICAL PLAZA, #B200, LOS ANGELES, CA 90095-0001
(310) 794-1195
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
(310) 301-8707
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
A53511
CA
2084N0400X
Neurology Physician
Primary
J6499
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A535110
—
CA
Enumeration date
07/14/2006
Last updated
12/05/2025
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