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NPI Code Detail

MEDICARE: DR. ANDREW JORDAN DC

MEDICARE: DR. ANDREW JORDAN DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111NN0400XNeurology Chiropractor34004CA

General Provider Information

NPI Number : 1851804348
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREW JORDAN DC
Provider Business Mailing Address
First Line : 810 GONZALEZ DR APT 4A
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94132-2221
Country : US
Telephone Number : 410-340-6121
Fax Number :
Provider Business Practice Location Address
First Line : 1545 BROADWAY # 1A
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94109-2539
Country : US
Telephone Number : 415-563-3800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2017
Last Update Date : 11/07/2017

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