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1043535560
ROBERTO FERNANDO JORDAN
LOS ANGELES, CA
NPI
1043535560
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: CA A108577)
Enumeration Date
2010-03-29
Last Update Date
2019-10-02
Business Address
Dr. ROBERTO FERNANDO JORDAN MD
1400 S GRAND AVE STE 101
LOS ANGELES, CA 90015-3048
Phone number: 213-744-0801
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Mailing Address
Dr. ROBERTO FERNANDO JORDAN MD
PO BOX 26666 PROVIDER ENROLLMENT
ALBUQUERQUE, NM 87125-6666
Phone number: 505-923-6770
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