Individual provider · Type 1 NPI

Mykala Jordan

Surgical Physician Assistant · San Diego, CA

NPI number 1710650940 Active

Practice location

6655 Alvarado Rd
San Diego, CA 92120-5208

Mailing address

File 57326
Los Angeles, CA 90074-7326

Other practice locations

  • 10 Martin Ave Ste 225, Naperville, IL 60540-6590 · (630) 355-5633
  • 1N463 Ingalton Ave, West Chicago, IL 60185-2022 · (619) 922-9693

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X085.008678 (IL)
Surgical Physician Assistant Primary 363AS0400XPA63739 (CA)

Surgical Physician Assistant: Definition to come...

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About NPI 1710650940

Mykala Jordan's National Provider Identifier is 1710650940, issued on Jul 25, 2021. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in San Diego, CA. The record was last updated on Nov 21, 2025.