Individual
MR. HENRY JORDAN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11301 WILSHIRE BLVD, LOS ANGELES, CA 90073-1003
(310) 478-3711
Mailing address
11301 WILSHIRE BLVD, LOS ANGELES, CA 90073-1003
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
00862467
CA
Other
Enumeration date
09/12/2014
Last updated
09/12/2014
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