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NPI Profile for Dr CODY R JACKSON in SAN DIEGO, CA.
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
General Practice |
208D00000X | 99 | Physician/Undefined Physician type[6] | |
Occupational Medicine |
2083X0100X | 84 | Physician/Preventive Medicine | |
Student in an Organized Health Care Education/Training Program |
390200000X |
| NPI Number | 1770715146 |
|
| Status | Active | |
| Credentials | MD | |
| Entity | Individual | |
| Enumeration date | 08/18/2009 | |
| Last updated | 07/05/2022 - About 4 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
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|
| Hospital affiliation(s) | Not Available |
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CODY R JACKSON
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CODY R JACKSON, MD