Dr. Charles William Jackson, M.D.
General Practice in Huntington Beach, CA. Individual provider (NPI-1).
NPI number1083662845
StatusActive
Last updated in NPPESJul 30, 2010
Details
- NPI
- 1083662845
- Entity type
- Individual (NPI-1)
- Name
- Dr. Charles William Jackson
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 4, 2006
- Last updated
- Jul 30, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | G35311 | CA | Yes |
Practice location
17122 Beach BlvdSuite 102
Huntington Beach, CA 92647-5992
Phone 714-847-6545 · Fax 714-847-6547
Mailing address
17122 Beach BlvdSuite 102
Huntington Beach, CA 92647-5992
Phone 714-847-6545 · Fax 714-847-6547
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All 16 General Practice Physician providers in Huntington Beach · All 5,320 providers in Huntington Beach
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