DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

KEITH A JACKSON, MD

Active Sole Proprietor

Otolaryngology · SAN DIEGO, CA

Registration Details

NPI Number
1124091970
Provider Type
Individual
Gender
Male
NPI Issued
Feb 10, 2006 (20.195949895072 yrs)
Last Updated
Jan 25, 2024
Licenses
G58187 (CA)
8547 (NV)
8547 (NV)
Sole Proprietor
Yes

Practice Information

Address
5405 OBERLIN DR FL 2
SAN DIEGO, CA, 921211700
Browse CA providers · Browse ZIP 92121
Phone
8589090770
Fax
8589090880
Primary Specialty
Otolaryngology
207Y00000X
Additional Specialty
Otolaryngic Allergy
Additional Specialty
Otolaryngology

Other Otolaryngology Providers in SAN DIEGO, CA

Name Credential NPI
DR. THEODORE M. MAZER M.D. 1598768327
JAMES ESTES BUSH MD 1932108867
DR. KEVIN THOMAS BRUMUND MD 1033193669
MICHAEL RAY HOLTEL M.D. 1073584397
DR. QUYEN T. NGUYEN M.D. 1477524452
DR. ALEXANDER STEWART MD 1093788226
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.