Individual
JOHN E JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4101 TORRANCE BLVD, TORRANCE, CA 90503
(310) 303-5750
(310) 303-5709
Mailing address
DEPT LA 21552, PASADENA, CA 91185-1552
(949) 263-8600
(949) 263-1639
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G60013
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G600130
BLUE SHIELD
CA
05
—
00G600130
—
CA
Enumeration date
11/16/2005
Last updated
04/25/2013
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