Doctor Name: | REBECCA S JORDAN |
NPI Number: | 1649243528 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | A53618 |
Business Practice Address: | 7600 Hospital Dr Suite G Sacramento, CA - 958235406 |
Business Phone Number: | 9165252021 |
Business Fax Number: | 9165252065 |
Mailing Address: | 7600 Hospital Dr, Suite G SACRAMENTO |
State: | CA |
Postal Code: | 958235406 |
Phone Number: | 9165252021 |
Fax Number: | 9165252065 |
NPI Enumeration Date: | 02/09/2006 |
NPI Last Update Date: | 05/31/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A53618 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |