| Richard K Gordon MD Inc | |
|
18250 Roscoe Blvd Suite 250 Northridge CA 91325-4226 | |
| (818) 770-7090 | |
| Not Available |
| Full Name | Richard K Gordon MD Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 18250 Roscoe Blvd, Northridge, California |
| Authorized Official Name and Position | Richard K Gordon (OWNER) |
| Authorized Official Contact | 8187727090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard K Gordon MD Inc 8700 Reseda Blvd Suite 204 Northridge CA 91324-4041 Ph: (818) 772-7090 | Richard K Gordon MD Inc 18250 Roscoe Blvd Suite 250 Northridge CA 91325-4226 Ph: (818) 770-7090 |
| NPI Number | 1811205545 |
|---|---|
| Provider Enumeration Date | 09/15/2010 |
| Last Update Date | 01/13/2011 |
| Medicare PECOS PAC ID | 4385826213 |
|---|---|
| Medicare Enrollment ID | O20110314000427 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811205545 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | G56286 (California) | Primary |
| Provider Name | Richard Gordon |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1144242645 PECOS PAC ID: 9830096536 Enrollment ID: I20110314000460 |
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