Gordon, John B
Gordon, John B is an individual health care provider with primary practice located at 3131 Berger Ave Ste 200 , San Diego CA 92123-4203. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Gordon, John B can be contacted via phone (858) 244-6865.Contact Information
Primary practice address
3131 Berger Ave Ste 200
San Diego CA 92123-4203
Phone: (858) 244-6865
Fax: (858) 244-6909
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | C42631 | California |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | C42631 | California |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | C42631 | California |
Profile Details
| NPI number | 1962483099 |
|---|---|
| LBN Legal business name | Gordon, John B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 7th, 2005 |
| Last updated | Jun 3rd, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962483099 | NPPES |
| California | MEDICAID | 00C426310 |
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