1700289329 NPI number — MICHELLE ANNA JORDEN M.D.

Table of content: MICHELLE ANNA JORDEN M.D. (NPI 1700289329)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700289329 NPI number — MICHELLE ANNA JORDEN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JORDEN
Provider First Name:
MICHELLE
Provider Middle Name:
ANNA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700289329
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/10/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
850 THORNTON WAY
Provider Second Line Business Mailing Address:
SANTA CLARA COUNTY MEDICAL EXAMINER-CORONER OFFICE
Provider Business Mailing Address City Name:
SAN JOSE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95128
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
850 THORNTON WAY
Provider Second Line Business Practice Location Address:
SANTA CLARA COUNTY MEDICAL EXAMINER-CORONER OFFICE
Provider Business Practice Location Address City Name:
SAN JOSE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95128-4702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-793-1900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/28/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207ZF0201X , with the licence number:  A76862 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207ZF0201X , with the licence number: 036.113905 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)