Individual
DR. SUSANNA REBA GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6939 PALM CT, RIVERSIDE, CA 92506-2815
(951) 683-6771
Mailing address
PO BOX 512185, LOS ANGELES, CA 90051-0185
(626) 775-3514
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
34232
IA
2085R0001X
Radiation Oncology Physician
49114
CO
2085R0001X
Radiation Oncology Physician
Primary
G84560
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1246710
—
IA
01
—
CA142866
MEDICARE PTAN
CA
01
—
CA153446
MEDICARE PTAN
CA
01
—
CB216780
MEDICARE PTAN
CA
Enumeration date
07/12/2005
Last updated
12/15/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us