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Contact Information

TOMMY JACKSON
1760 TERMINO AVE
208
LONG BEACH, CA90804-2105
 Phone: 562-961-5655
 Fax: 562-961-8836
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Assistant

246ZX2200X
Indicates primary specialty

NPI Profile & details for TOMMY JACKSON · (Male)

NPI # 1497297154
Status Active
Credentials
Entity Individual
Enumeration date 11/12/2016
Last updated 11/12/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • CA License # 02-0922
  • CA Other 02-0922 NATIONAL BOARD FOR CERTIFICATION OF ORTHOPAEDIC TECHNOLOGISTS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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