Provider Demographics
NPI:1619145521
Name:SAVARA, JORDAN JEFFREY (DC)
Entity Type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:JEFFREY
Last Name:SAVARA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 NORTHLAKE DR APT 202
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95117-1328
Mailing Address - Country:US
Mailing Address - Phone:408-386-1771
Mailing Address - Fax:
Practice Address - Street 1:2100 GORDON AVE
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-6520
Practice Address - Country:US
Practice Address - Phone:650-233-7333
Practice Address - Fax:650-233-7330
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30816111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor