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General NPI Number Information
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NPI Number | 1598655326
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Entity Type | Organization
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Legal Business Name | BREANNA R. FREEMAN-JORDAN MD, INC.
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Dates
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Enumeration Date | 07/03/2025
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 233 N PRAIRIE AVE
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City | INGLEWOOD
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State | CA
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Zip | 90301-1412
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Country | US
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Telephone | 310-673-6581
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 431449
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City | LOS ANGELES
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State | CA
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Zip | 90043-9449
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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 | OWNER/PRESIDENT
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Name | DR. BREANNA RENEA FREEMAN-JORDAN
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Credential |
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Telephone | 424-256-5795
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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