Healthcare Provider Details

I. General information

NPI: 1952911331
Provider Name (Legal Business Name): JORDANMED HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2020
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 HOSPITAL DR STE K
SACRAMENTO CA
95823-5406
US

IV. Provider business mailing address

7600 HOSPITAL DR STE K
SACRAMENTO CA
95823-5406
US

V. Phone/Fax

Practice location:
  • Phone: 916-718-0002
  • Fax: 279-250-8881
Mailing address:
  • Phone: 916-718-0002
  • Fax: 279-250-8881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: GREGORY GERALD SMITH
Title or Position: PHYSICIAN
Credential: MD
Phone: 916-718-0002