Individual
CLARA GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10121 PINE AVE, TRUCKEE, CA 96161-4856
(530) 587-6011
Mailing address
PO BOX 1460, TRUCKEE, CA 96160-1460
(207) 577-1809
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
1102870
MA
363A00000X
Physician Assistant
PA2308
ME
363A00000X
Physician Assistant
PA2351
NV
363A00000X
Physician Assistant
Primary
PA52487
CA
Other
Enumeration date
11/17/2011
Last updated
10/14/2022
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