Individual
JORDAN ELISABETH BASHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
400 N PEPPER AVE, COLTON, CA 92324-1801
(855) 422-8029
Mailing address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 747-0371
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
A156671
CA
2086S0102X
Surgical Critical Care Physician
Primary
A156671
CA
Other
Enumeration date
05/18/2016
Last updated
12/26/2025
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