Provider Demographics
NPI:1609171982
Name:JARDON, JAVIER ANTONIO (MD)
Entity Type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:ANTONIO
Last Name:JARDON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 762
Mailing Address - Street 2:
Mailing Address - City:MAYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90270-0762
Mailing Address - Country:US
Mailing Address - Phone:323-749-8100
Mailing Address - Fax:323-749-8101
Practice Address - Street 1:4131 SLAUSON AVE
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90270-2833
Practice Address - Country:US
Practice Address - Phone:323-749-8100
Practice Address - Fax:323-749-8101
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-19
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA131365207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology