| Organization Name: | ERIC JACKSON-SCOTT MD INC |
| NPI Number: | 1538439302 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ERIC JACKSON-SCOTT (MEDICAL DIRECTOR) |
| Mailing Address: | 455 N Prairie Ave Inglewood |
| State: | CA US |
| Postal Code: | 903011413 |
| Phone Number: | 3104120183 |
| Fax Number: | |
| NPI Enumeration Date: | 01/10/2012 |
| NPI Last Update Date: | 01/10/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | A115195 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |