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Individual

HERSCHEL W GORDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
275 HOSPITAL DR, DEPT OF PATHOLOGY, UKIAH, CA 95482-4531
(707) 462-3111
(707) 463-7509
Mailing address
275 HOSPITAL DR, DEPT OF PATHOLOGY, UKIAH, CA 95482-4531
(707) 462-3111
(707) 463-7509

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
C20719
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00C207190
CA
Enumeration date
09/12/2005
Last updated
10/09/2014
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