Individual
JAY LOUIS JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8631 W 3RD ST, SUITE 445E, LOS ANGELES, CA 90048-5901
(310) 854-5493
(310) 289-7941
Mailing address
8631 W 3RD ST, SUITE 445E, LOS ANGELES, CA 90048-5901
(310) 854-5493
(310) 289-7941
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A25646
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BU936Z
MEDICARE
CA
Enumeration date
07/27/2006
Last updated
01/07/2015
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