| Jordan Neuroservices A Medical Corporation | |
|
1660 Plum Ln Redlands CA 92374-4532 | |
| (909) 881-1031 | |
| Not Available |
| Full Name | Jordan Neuroservices A Medical Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1660 Plum Ln, Redlands, California |
| Authorized Official Name and Position | Kenneth George Jordan (PRESIDENT / OWNER) |
| Authorized Official Contact | 9098811031 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jordan Neuroservices A Medical Corporation 1660 Plum Ln Redlands CA 92374-4532 Ph: (909) 881-1031 | Jordan Neuroservices A Medical Corporation 1660 Plum Ln Redlands CA 92374-4532 Ph: (909) 881-1031 |
| NPI Number | 1851510663 |
|---|---|
| Provider Enumeration Date | 04/24/2007 |
| Last Update Date | 07/09/2024 |
| Certification Date | 07/09/2024 |
| Medicare PECOS PAC ID | 6709970387 |
|---|---|
| Medicare Enrollment ID | O20070913000745 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851510663 | NPI | - | NPPES |
| 00G283910 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Kenneth Jordan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477537116 PECOS PAC ID: 1254425820 Enrollment ID: I20070913000739 |
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