person
Mr. Bruce L Jackson, PA
Medical Physician Assistant in Apple Valley, California
NPI 1124072087

Bruce L Jackson is a Medical Physician Assistant based in Hesperia, CA and is specialized in Medical. Bruce L Jackson practices in Apple Valley, CA and has the professional credentials of PA. The NPI Number for Bruce L Jackson is 1124072087 and holds a License No. PA14185 (California).

The current practice location address for Bruce L Jackson is 15863 Kasota Rd, Apple Valley, CA and can be reached out via phone at 760-948-1454 and via fax at 760-948-6100.

Location: 15863 Kasota Rd, Apple Valley, CA, 92345-1855
person
Provider Profile Details
NPI Number
1124072087
Provider Name
Bruce L Jackson
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
15863 Kasota Rd, Apple Valley, CA, 92345-1855
Phone Number
760-948-1454
Fax Number
760-948-6100
Provider Enumeration Date
05/22/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
GR0050902 05 CA
institution
Provider Business Practice Location Address Details
Address
15863 Kasota Rd
City
State
Zip
92307-4507
Phone Number
760-948-1454
Fax Number
760-948-6100
person
Provider Business Mailing Address Details
Address
15863 Kasota Rd
City
State
Zip
92307-4507
Phone Number
760-948-1454
Fax Number
760-948-6100
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA14185 (California)
Definition
Definition to come...
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