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Organization
JORDAN M USUNOV M D A PROFESSIONAL CORPORATION
Active
Organization
JORDAN M USUNOV M D A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN M USUNOV MD (MD/DOCTOR)
(209) 836-2223
Entity
Organization
Contact information
Practice address
1540 N TRACY BLVD, A, TRACY, CA 95376-2530
(209) 836-2223
(209) 836-2530
Mailing address
1540 N TRACY BLVD, A, TRACY, CA 95376-2530
(209) 836-2223
(209) 836-2530
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
08/01/2007
Last updated
01/23/2013
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