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General NPI Number Information
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NPI Number | 1326501180
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Entity Type | Individual
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Provider Name | YUSEF JORDAN MD
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Gender | Male
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Dates
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Enumeration Date | 04/09/2019
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Last Update Date | 07/26/2024
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Provider Practice Location Address
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Address Line | 6190 CORNERSTONE CT E STE 212
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City | SAN DIEGO
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State | CA
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Zip | 92121-4701
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Country | US
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Telephone | 858-246-6305
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Fax |
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Provider Business Mailing Address
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Address Line | 535 E 70TH ST
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City | NEW YORK
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State | NY
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Zip | 10021-4823
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | A194293
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License Number State | CA
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