Individual provider · Type 1 NPI

Titus Clinton Jackson, PA-C

Surgical Physician Assistant · Los Angeles, CA

NPI number 1700224011 Active

Practice location

444 S San Vicente Blvd Ste 603
Los Angeles, CA 90048-4178

Call (310) 423-4566 Map

Other practice locations

  • 8700 Beverly Blvd, West Hollywood, CA 90048-1804 · (310) 423-4566

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X99220 (CA)

Surgical Physician Assistant: Definition to come...

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About NPI 1700224011

Titus Clinton Jackson, PA-C's National Provider Identifier is 1700224011, issued on Jun 8, 2013. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Los Angeles, CA. The record was last updated on Mar 1, 2024.