Most Relevant Information
Provider Data
NPI Number: | 1003055401 |
Provider Name: | JACKSON W PENRY MD |
Entity Type: | Individual |
Taxonomy Code: | 2085R0202X |
Specialty: | Radiology |
License Number: | A114302 |
Most Important Dates
Enumeration Date: | 02/10/2009 |
Last Updated: | 07/29/2014 |
Provider Practice Location
27700 MEDICAL CENTER ROAD-RADIOLOGY DEPARTMENT
MISSION VIEJO
CA
926916426
Practice Location Phone/Fax
Phone: | 9493647744 |
Fax: |
Provider Mailing Location
DEPT LA 21789
PASADENA
CA
911851789
Provider Mailing Phone/Fax
Phone: | 9492638620 |
Fax: | 8004097005 |