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1104502467
JORDAN AMBROSE JEREMIAH
LOS ANGELES, CA
NPI
1104502467
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-06-22
Last Update Date
2023-06-22
Business Address
JORDAN AMBROSE JEREMIAH
4063 WHITTIER BLVD STE 202
LOS ANGELES, CA 90023-2536
Phone number: 323-268-2100
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Mailing Address
JORDAN AMBROSE JEREMIAH
14308 OHIO ST
BALDWIN PARK, CA 91706-2553
Phone number: 626-838-4805
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