Individual
DR. GORDON T MA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1459 FERNWOOD ST, WEST SACRAMENTO, CA 95691-3626
(916) 371-4222
Mailing address
1459 FERNWOOD ST, WEST SACRAMENTO, CA 95691-3626
(916) 371-4222
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
AFE18861
CA
Other
Enumeration date
12/25/2012
Last updated
12/25/2012
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