Individual
MARK R GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2870 WHIPTAIL LOOP STE 201, CARLSBAD, CA 92010-6766
(667) 243-5377
Mailing address
2870 WHIPTAIL LOOP STE 201, CARLSBAD, CA 92010-6766
(760) 331-9771
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
3929
SD
207RC0000X
Cardiovascular Disease Physician
5823A
WY
207RC0000X
Cardiovascular Disease Physician
Primary
G-168143
CA
207RC0000X
Cardiovascular Disease Physician
MD2020-0673
NM
207RC0000X
Cardiovascular Disease Physician
MD220295
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008426
SD BCBS
SD
05
—
0549402
—
IA
01
—
101T6GO
MN BCBS - PLAN 91057NO
MN
01
—
10492
HEALTHPARTNERS
—
01
—
165025
UCARE
MN
01
—
25-00667
MEDICA SELECTCARE
—
05
—
331503700
—
MN
01
—
33333
IA BCBS #
IA
01
—
346L9GO
MN BCBS - PLAN 538R2NO
MN
01
—
3929
DAKOTACARE
SD
05
—
6002892
—
SD
01
—
931451030123
PREFERRED ONE
—
Enumeration date
05/04/2006
Last updated
06/27/2025
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