Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | OC013999 | PA |
NPI | 1609313881 |
---|---|
Provider Name | Jordan Mcmaster |
First Address | Sherman Oaks, CA 91403-1173 |
Second Address | Sherman Oaks, CA 91403-1173 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2017 |
Last Update Date | 25/01/2017 |