Individual
DR. EARL MARK GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2021 SANTA MONICA BLVD STE 421E, SANTA MONICA, CA 90404-2144
(310) 453-4599
(310) 453-6620
Mailing address
2001 SANTA MONICA BLVD, SUITE # 765 - W, SANTA MONICA, CA 90404-2102
(310) 453-4599
(310) 453-6620
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
G 35140
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G 35140
CALIFORNIA MED. LICENSE
CA
05
—
ZZZ 73491 Z
—
CA
Enumeration date
04/10/2007
Last updated
11/21/2022
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