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Individual

WELDON KARL JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA CCC-A

Contact information

Practice address
28125 BRADLEY RD, SUITE 140, SUN CITY, CA 92586-2248
(951) 679-8751
(951) 679-8751
Mailing address
28125 BRADLEY RD, SUITE 140, SUN CITY, CA 92586-2248
(951) 679-8751
(951) 679-8751

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AU 1237
CA
237700000X
Hearing Instrument Specialist
HA 1750
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4A 1750
CA
Enumeration date
08/05/2007
Last updated
07/08/2008
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