Gordon, Richard Kenneth
Gordon, Richard Kenneth is an sole proprietor health care provider with primary practice located at 8700 Reseda Blvd Suite 204, Northridge CA 91324-4041. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Gordon, Richard Kenneth can be contacted via phone (818) 772-7090.Contact Information
Primary practice address
8700 Reseda Blvd Suite 204
Northridge CA 91324-4041
Phone: (818) 772-7090
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Other Service Providers / Specialist | 174400000X | G56286 | California |
Profile Details
NPI number | 1144242645 |
---|---|
LBN Legal business name | Gordon, Richard Kenneth |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jul 24th, 2006 |
Last updated | Jan 13th, 2011 - about 14 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 | 1144242645 | NPPES |
California | MEDICAID | 00G562860 |
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