Organization
JEAN GORDON, M.D. PH.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEAN GORDON M.D., PH.D, (M.D.)
(650) 938-6559
Entity
Organization
Contact information
Practice address
2660 SOLACE PL STE C, MOUNTAIN VIEW, CA 94040-4316
(650) 938-6559
(650) 938-6510
Mailing address
2660 SOLACE PL STE C, MOUNTAIN VIEW, CA 94040-4316
(650) 938-6559
(650) 938-6510
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G60973
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G609730
MEDICARE PROVIDER NUMBER
CA
Enumeration date
09/18/2007
Last updated
09/18/2007
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