Organization
PACIFIC MEDICAL AND NEPHROLOGY ASSOCIATES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EARL MARK GORDON MD (PRESIDENT OF CORPORATION)
(310) 453-4599
Entity
Organization
Contact information
Practice address
2001 SANTA MONICA BLVD, SUITE 765W, SANTA MONICA, CA 90404-2102
(310) 453-4599
(310) 453-6620
Mailing address
2001 SANTA MONICA BLVD, SUITE 765W, SANTA MONICA, CA 90404-2102
(310) 453-4599
(310) 453-6620
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
G35140
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ73491Z
—
CA
Enumeration date
03/31/2006
Last updated
06/09/2020
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