Dale Jacknow

NPI 1194959569 - Pediatrics - 2080P0006X

NPI Details
NPI 1194959569
Gender Female
Enumeration Date 05/13/2009
Last Updated 05/13/2009
Entity Type Individual
Active Over 7 years ago
Practice Location
101 S SAN MATEO DR
SUITE 208
SAN MATEO CA, 94401-3819, US
Phone (650) 342-3137
Fax
Business Location
101 S SAN MATEO DR
SUITE 208
SAN MATEO CA, 94401-3819, US
Phone
Fax
Toxanomy
Taxonomy Code 2080P0006X
License State California
License Number 657898
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According to our database, Dale Jacknow NPI is 1194959569, taxonomy code is 2080P0006X and license number is 657898, license state is located at California. Dale Jacknow physically located at 101 S San Mateo Dr, San Mateo CA, 94401-3819. NPI Number Dale Jacknow has the Individual type.

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1194959569 NPI number is provided on an as is basis without warranty of any kind. 1194959569 is maintained by the National Plan & Provider Enumeration System. The contents of Dale Jacknow are for informational purposes only.