Provider Demographics
NPI:1598372229
Name:ESMAIL, AMIR JORDAN
Entity Type:Individual
Prefix:
First Name:AMIR JORDAN
Middle Name:
Last Name:ESMAIL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21515 HAWTHORNE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-6512
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:855-876-1466
Practice Address - Street 1:21515 HAWTHORNE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-6512
Practice Address - Country:US
Practice Address - Phone:855-876-1466
Practice Address - Fax:855-876-1466
Is Sole Proprietor?:No
Enumeration Date:2020-09-27
Last Update Date:2020-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide