Robert Jack, M.D

NPI 1154338515 · on the registry since 2006 · sole proprietor

Practice

Address: 8717 La Tijera Blvd
Los Angeles, CA 90045
Phone: (310) 645-4393
Fax: (310) 645-4508
Organisation at this address: Michael Gadsby, M.D., Incorporated
Lawrence T. Goodwin, Jr., M.D., Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 2

Registry record

Primary taxonomy: 207W00000X
207W00000X
Licence states on file: CA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2007-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California