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General NPI Number Information
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NPI Number | 1952911331
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Entity Type | Organization
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Legal Business Name | JORDANMED HEALTH, INC.
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Dates
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Enumeration Date | 07/31/2020
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Last Update Date | 07/31/2020
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Provider Practice Location Address
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Address Line | 7600 HOSPITAL DR STE J
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City | SACRAMENTO
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State | CA
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Zip | 95823-5406
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Country | US
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Telephone | 916-525-2021
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Fax |
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Provider Business Mailing Address
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Address Line | 7600 HOSPITAL DR STE J
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City | SACRAMENTO
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State | CA
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Zip | 95823-5406
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Country | US
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Telephone | 916-525-2021
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | REBECCA JORDAN
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Credential | MD
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Telephone | 916-525-2021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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