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1265051411
TERENCE JORDAN ELLIS
SACRAMENTO, CA
NPI
1265051411
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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
2020-04-08
Last Update Date
2020-04-08
Business Address
TERENCE JORDAN ELLIS MD
2516 STOCKTON BLVD
SACRAMENTO, CA 95817-2208
Phone number: 916-734-2428
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Mailing Address
TERENCE JORDAN ELLIS MD
2516 STOCKTON BLVD
SACRAMENTO, CA 95817-2208
Phone number: 916-734-2428
Copy
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