Individual provider · Type 1 NPI

Jordan Ambrose Jeremiah

Student in an Organized Health Care Education/Training Program · Los Angeles, CA

NPI number 1104502467 Active

Practice location

4063 Whittier Blvd Ste 202
Los Angeles, CA 90023-2536

Call (323) 268-2100 Map

Mailing address

14308 Ohio St
Baldwin Park, CA 91706-2553

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1104502467

Jordan Ambrose Jeremiah's National Provider Identifier is 1104502467, issued on Jun 22, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Los Angeles, CA. The record was last updated on Jun 22, 2023.