Individual
MR. CHARLES F JACKSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
34800 BOB WILSON DRIVE, NAVAL MEDICAL CENTER, SAN DIEGO, SAN DIEGO, CA 92134-5000
(619) 524-4904
Mailing address
6320 LAKE ATHABASKA PL, SAN DIEGO, CA 92119-3527
(619) 465-4621
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AT-001058-L
PA
Other
Enumeration date
01/06/2006
Last updated
07/08/2007
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