Tara Jackson Glenn
MD | Pediatric Neonatal-Perinatal Medicine | Female
Tara Jackson Glenn, MD is a La Jolla, California based Pediatric doctor with medical specialization in
Pediatric Neonatal-Perinatal Medicine. Tara Jackson Glenn is also known as
Tara Christine Jackson.
Current practice location of Tara Jackson Glenn is
9300 Campus Point Dr, La Jolla, California - 92037-1300. She can be contacted on phone at
858-249-5800.
Tara Jackson Glenn is a sole proprietor of her business.
NPI number (Unique professional ID) for Tara Jackson Glenn is
1992060974 which was assigned by NPPES on 06 Jul, 2012 and it was last updated on 08 Apr, 2021.
Tara Jackson Glenn license number is
A170207 for Pediatrics Neonatal-Perinatal Medicine (2080N0001X) in California.
Tara Jackson Glenn is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.
Complete Profile:
Tara Jackson Glenn basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Neonatal-Perinatal Medicine |
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| Provider Name : | Tara Jackson Glenn |
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| Other Name : | Tara Christine Jackson |
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| Credential : | MD |
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| Gender : | Female |
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Business Address:
Tara Jackson Glenn address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 9300 Campus Point Dr
La Jolla, CA, 92037-1300
United States |
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| Phone Number : | 858-249-5800 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1992060974 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 06 Jul, 2012 |
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| Last Updated On : | 08 Apr, 2021 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Tara Jackson Glenn are as mentioned. Primary taxonomy code for Tara Jackson Glenn, MD is
2080N0001X (Pediatrics Neonatal-Perinatal Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | No | 35-126046 | OH |
| 208000000X | Pediatrics | No | A170207 | CA |
| 2080N0001X | Pediatrics Neonatal-Perinatal Medicine | Yes | A170207 | CA |
Legacy Identifiers:
Other legacy medical identifiers of Tara Jackson Glenn such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
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| 0148250 | MEDICAID | OH | |
Other Practice Locations:
| Practice Address | City, State | Phone Number |
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3010 CHILDRENS WAY,
SAN DIEGO, CA, 92123-4223
United States | SAN DIEGO, CA | 858-966-5818 |
11100 EUCLID AVE,
CLEVELAND, OH, 44106-1716
United States | CLEVELAND, OH | 216-844-7700 |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 3020 Childrens Way # Mc5003
San Diego, CA, 92123-4223
United States |
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| Phone Number : | 858-309-6300 |
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Business Location:
Patients can refer following map for directions to
Tara Jackson Glenn practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.