| Doctor Name: | ANITA CAL JACKSON |
| NPI Number: | 1063519486 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | A053675 |
| Business Practice Address: | 44274 George Cushman Ct Suite 212 Temecula, CA - 925925945 |
| Business Phone Number: | 9516944688 |
| Business Fax Number: | 9516944760 |
| Mailing Address: | 1545 W Florida Ave, HEMET |
| State: | CA |
| Postal Code: | 925433814 |
| Phone Number: | 9517911111 |
| Fax Number: | 9519253606 |
| NPI Enumeration Date: | 09/20/2006 |
| NPI Last Update Date: | 01/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0505X |
| License Number: | A053675 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adult Medicine |
| Taxonomy Definition: | |