Provider Demographics
NPI:1013949320
Name:JORDIN, MATTHEW C (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:C
Last Name:JORDIN
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 1:721 W WHITTIER BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-3759
Mailing Address - Country:US
Mailing Address - Phone:562-905-3434
Mailing Address - Fax:562-905-2626
Practice Address - Street 1:721 W WHITTIER BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-3759
Practice Address - Country:US
Practice Address - Phone:562-905-3434
Practice Address - Fax:562-905-2626
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-27613111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC27613Medicare PIN