Active NPI
David Joseph Jordan
- Massage Therapist
- Redondo Beach, CA
National Provider Identifier
1871022657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 48198
- Practice address
- 1903 Bataan Rd Apt 12
Redondo Beach, CA 90278-1316 - Phone
- (310) 606-1140
- NPI assigned
- Jun 6, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 48198 | CA | Primary |
Addresses
Primary practice location
1903 Bataan Rd Apt 12
Redondo Beach, CA 90278-1316
Mailing address
1903 Bataan Rd Apt 12
Redondo Beach, CA 90278-1316
Phone (310) 606-1140
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 48198 | Other | CA | MASSAGE THERAPY |
Other names 1
- David Joseph Jordan
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48198 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1871022657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1903 BATAAN RD APT 12",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902781316",
"telephone_number": "310-606-1140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1903 BATAAN RD APT 12",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902781316",
"telephone_number": "310-606-1140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "DAVID",
"middle_name": "JOSEPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-06-06",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "CA",
"license": "48198",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASSAGE THERAPY",
"identifier": "48198",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DAVID",
"last_name": "JORDAN",
"middle_name": "JOSEPH",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Redondo Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.