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Organization
PACIFIC MEDICAL AND NEPHROLOGY ASSOCIATES INC.
Active
Organization
PACIFIC MEDICAL AND NEPHROLOGY ASSOCIATES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EARL MARK GORDON MD (PRESIDENT OF CORPORATION)
(310) 453-4599
Entity
Organization
Contact information
Practice address
2001 SANTA MONICA BLVD, SUITE 765W, SANTA MONICA, CA 90404-2102
(310) 453-4599
(310) 453-6620
Mailing address
2001 SANTA MONICA BLVD, SUITE 765W, SANTA MONICA, CA 90404-2102
(310) 453-4599
(310) 453-6620
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
G35140
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ73491Z
—
CA
Enumeration date
03/31/2006
Last updated
06/09/2020
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