Search › California › 207Y00000X
Keith Jackson, MD
NPI 1124091970 · on the registry since 2006 · sole proprietor
Practice
- Address
- 5405 Oberlin Dr Fl 2
San Diego, CA 92121 - Phone
- (858) 909-0770
- Fax
- (858) 909-0880
- Clinicians at this address
- 11
Registry record
- Primary taxonomy
- 207Y00000X
207Y00000X
- Also registered as
- 207Y00000X
207YX0901X - Licence states on file
- CA, NV
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-01-25
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California