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Individual

JACK ROBERT THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4647 ZION AVE, SAN DIEGO, CA 92120-2507
(760) 323-6830
Mailing address
4647 ZION AVE, SAN DIEGO, CA 92120-2507

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
20A18136
CA
390200000X
Student in an Organized Health Care Education/Training Program
CA

Other

Enumeration date
04/19/2018
Last updated
05/20/2022
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