Individual
DR. BRUCE R. GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
270-26TH ST., SUITE 202, SANTA MONICA, CA 90402
(310) 457-4442
(310) 451-5674
Mailing address
270-26TH STREET, SUITE 202, SANTA MONICA, CA 90402
(310) 451-4442
(310) 451-5674
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY.757
CA
103TC0700X
Clinical Psychologist
PSY.757
CA
Other
Enumeration date
04/28/2011
Last updated
05/03/2011
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