Bruce L Jackson, P.A.
Physician Assistant, Medical in Apple Valley, CA. Individual provider (NPI-1).
NPI number1124072087
StatusActive
Last updated in NPPESJul 13, 2026
Details
- NPI
- 1124072087
- Entity type
- Individual (NPI-1)
- Name
- Mr. Bruce L Jackson
- Credential
- P.A.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 22, 2006
- Last updated
- Jul 13, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | PA14185 | CA | Yes |
Practice location
15863 Kasota RdApple Valley, CA 92307-4507
Phone 760-948-1454 · Fax 760-948-6100
Mailing address
11919 Hesperia RdHesperia, CA 92345-1855
Phone 760-948-1454 · Fax 760-948-6100
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