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Individual

MARK LORRY GORDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
16661 VENTURA BLVD, SUITE 716, ENCINO, CA 91436-1914
(818) 990-1166
Mailing address
16661 VENTURA BLVD, SUITE 716, ENCINO, CA 91436-1914
(818) 990-1166

Taxonomy

Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
A041223
CA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
A41223
CA

Other

Enumeration date
02/08/2007
Last updated
09/11/2025
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