Healthcare Provider Details

I. General information

NPI: 1902085822
Provider Name (Legal Business Name): SARA M JORDAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. SARA MURIEL MELTZER

II. Dates (important events)

Enumeration Date: 10/27/2007
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10666 N TORREY PINES RD
LA JOLLA CA
92037-1027
US

IV. Provider business mailing address

10790 RANCHO BERNARDO RD
SAN DIEGO CA
92127-5705
US

V. Phone/Fax

Practice location:
  • Phone: 858-824-5464
  • Fax: 858-964-3127
Mailing address:
  • Phone: 858-824-5464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberA101266
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA101266
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: