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General NPI Number Information
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NPI Number | 1366954364
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Entity Type | Individual
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Provider Name | JEAN-PAUL JORDAN L.AC
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Gender | Male
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Dates
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Enumeration Date | 10/30/2017
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Last Update Date | 10/30/2017
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Provider Practice Location Address
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Address Line | 1130 D ST STE 5
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City | RAMONA
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State | CA
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Zip | 92065-3927
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Country | US
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Telephone | 760-315-3947
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Fax |
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Provider Business Mailing Address
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Address Line | 1335 RAMONA ST
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City | RAMONA
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State | CA
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Zip | 92065-3227
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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