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Organization
MOBILE WOUND & DIAGNOSTICS INC
Active
Organization
MOBILE WOUND & DIAGNOSTICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY GORDON MD, WCC (PRESIDENT)
(415) 287-0859
Entity
Organization
Contact information
Practice address
165 ROWLAND WAY STE 208, NOVATO, CA 94945-5055
(415) 287-0859
(415) 202-6228
Mailing address
7 OAKMONT CT, SAN RAFAEL, CA 94901-1235
(404) 275-1396
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
—
—
174400000X
Specialist
Primary
—
—
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
—
—
Other
Enumeration date
12/17/2019
Last updated
12/17/2019
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