Individual
DR. ANTHONY K GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
165 ROWLAND WAY STE 208, NOVATO, CA 94945
(415) 429-4225
(415) 202-6228
Mailing address
165 ROWLAND WAY STE 208, NOVATO, CA 94945-5055
(415) 429-4225
(415) 202-6228
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
031432
GA
2085R0202X
Diagnostic Radiology Physician
Primary
G59522
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000449765AA
—
GA
01
—
202I300099
MEDICARE PROVIDER FOR OMRIB
GA
Enumeration date
03/29/2006
Last updated
05/08/2020
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