Carol A Jackson, M.D.
Otolaryngology in Newport Beach, CA. Individual provider (NPI-1).
NPI number1255434825
StatusActive
Last updated in NPPESJun 3, 2009
Details
- NPI
- 1255434825
- Entity type
- Individual (NPI-1)
- Name
- Carol A Jackson
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 7, 2006
- Last updated
- Jun 3, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Y00000X | Otolaryngology | G50085 | CA | Yes |
Practice location
361 Hospital RdSte 325
Newport Beach, CA 92663-3522
Phone 949-574-7744 · Fax 949-642-3686
Mailing address
361 Hospital RdSte 325
Newport Beach, CA 92663-3522
Phone 949-574-7744 · Fax 949-642-3686
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