Individual
JORDAN ANDREW SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A182611
CA
2080S0010X
Pediatric Sports Medicine Physician
A182611
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/10/2021
Last updated
01/30/2026
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