Organization
CARL J. GORDON, M.D. INC.
Active
Organization
CARL J. GORDON, M.D. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL JEFFREY GORDON M.D. (PRESIDENT)
(323) 931-2606
Entity
Organization
Contact information
Practice address
6360 WILSHIRE BLVD, SUITE 409, LOS ANGELES, CA 90048-5603
(323) 931-2606
(323) 931-2927
Mailing address
6360 WILSHIRE BLVD, SUITE 409, LOS ANGELES, CA 90048-5603
(323) 931-2606
(323) 931-2927
Taxonomy
Speciality
Code
Description
License number
State
261QS0132X
Ophthalmologic Surgery Clinic/Center
Primary
G9592
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000G95920
—
CA
01
—
G9592
CALIFORNIA MEDICAL LICENSE
CA
Enumeration date
07/11/2008
Last updated
07/14/2009
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