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Jackson W Penry, MD
Diagnostic Radiology Physician in Mission Viejo, California
NPI 1003055401

Jackson W Penry is a Diagnostic Radiology Physician based in Pasadena, CA and is specialized in Diagnostic Radiology. Jackson W Penry practices in Mission Viejo, CA and has the professional credentials of MD. The NPI Number for Jackson W Penry is 1003055401 and holds a License No. A114302 (California).

The current practice location address for Jackson W Penry is 27700 Medical Center Road-Radiology Department, Mission Viejo, CA and can be reached out via phone at 949-364-7744.

Location: 27700 Medical Center Road-Radiology Department, Mission Viejo, CA, 91185-1789
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1003055401
Provider Name
Jackson W Penry
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
27700 Medical Center Road-Radiology Department, Mission Viejo, CA, 91185-1789
Phone Number
949-364-7744
Fax Number
Provider Enumeration Date
02/10/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00A1143020 01 CA BS/BC OF CA
1003055401 05 CA
0A1143020 05 CA
institution
Provider Business Practice Location Address Details
Address
27700 Medical Center Road-Radiology Department
City
Mission Viejo
State
California
Zip
92691-6426
Phone Number
949-364-7744
Fax Number
person
Provider Business Mailing Address Details
Address
27700 Medical Center Road-Radiology Department
City
Mission Viejo
State
California
Zip
92691-6426
Phone Number
949-364-7744
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
2085R0202X
License No.
A114302 (California)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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