Provider Demographics
NPI:1790859270
Name:SHLAIN, JORDAN LEWIS (MD)
Entity Type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:LEWIS
Last Name:SHLAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3580 CALIFORNIA ST.
Mailing Address - Street 2:#101
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118
Mailing Address - Country:US
Mailing Address - Phone:415-830-3090
Mailing Address - Fax:415-520-5191
Practice Address - Street 1:3580 CALIFORNIA ST.
Practice Address - Street 2:#101
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118
Practice Address - Country:US
Practice Address - Phone:415-830-3090
Practice Address - Fax:415-520-5191
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2011-05-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA60022207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine