Jorgensen, Michael B

Jorgensen, Michael B is an individual health care provider with primary practice located at 450 Broadway St Pavilion A, 2Nd Floor, Redwood City CA 94063-3132. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Jorgensen, Michael B can be contacted via phone (818) 621-6612.

Contact Information

Primary practice address
450 Broadway St Pavilion A, 2Nd Floor Redwood City CA 94063-3132
Phone: (818) 621-6612
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 01693T Iowa

Profile Details

NPI number 1457302101
LBN Legal business name Jorgensen, Michael B
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 15th, 2006
Last updated May 26th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457302101 NPPES
Other IA01B9 JOHN DEERE HEALTH

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