Individual
DR. KENNETH L. GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
C36598
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C365980
K.L. GORDON BL/SHLD #
CA
01
—
10019
K.L. GORDON M.D. MES #
CA
01
—
26923
SPECTERA GROUP PROVIDER #
CA
01
—
33106001
K.L. GORDON -DAVIS VISION
CA
01
—
891978
K.L. GORDON -BLOCK VISION
CA
01
—
CA0783
EYE MED GROUP PROVIDER #
CA
05
—
GR0071730
—
CA
01
—
P-11051496
K.L. GORDON MULTI-PLAN #
CA
Enumeration date
08/10/2006
Last updated
09/27/2007
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