Individual provider · Type 1 NPI

Bruce L. Jackson, P.A.

Medical Physician Assistant · Apple Valley, CA

NPI number 1124072087 Active

Practice location

15863 Kasota Rd
Apple Valley, CA 92307-4507

Call (760) 948-1454 Map

Fax (760) 948-6100

Mailing address

11919 Hesperia Rd
Hesperia, CA 92345-1855

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA14185 (CA)

Medical Physician Assistant: Definition to come...

5 other providers at this address

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About NPI 1124072087

Bruce L. Jackson, P.A.'s National Provider Identifier is 1124072087, issued on May 22, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Apple Valley, CA. The record was last updated on Jul 13, 2026.