Individual
ELISE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
910 SYCAMORE AVE STE 270, VISTA, CA 92081-7852
(760) 598-1776
Mailing address
FILE NO 749733, LOS ANGELES, CA 90074-9733
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/03/2016
Last updated
04/18/2019
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