Healthcare Provider Details

I. General information

NPI: 1821944810
Provider Name (Legal Business Name): JORDAN BORRAYO DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1870 WESTWOOD BLVD
LOS ANGELES CA
90025-4612
US

IV. Provider business mailing address

10345 POPLAR STREET
RANCHO CUCAMONGA CA
91737
US

V. Phone/Fax

Practice location:
  • Phone: 909-223-6326
  • Fax:
Mailing address:
  • Phone: 909-223-6326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC37553
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: