Dr. Earl Mark Gordon
Nephrologist
2001 Santa Monica Blvd Suite # 765 - W
Santa Monica
, California 90404-2102
Dr. Earl Mark Gordon
Nephrologist
2001 Santa Monica Blvd Suite # 765 - W
Santa Monica
, California 90404-2102
(310) 453-6620
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About
Features
Specialties
- Nephrologist
Languages spoken
- English
Location
First Address
- Dr. Earl Mark Gordon
- 2001 Santa Monica Blvd Suite # 765 - W
- Santa Monica, CA
- Zip : 90404-2102
- Fax : (310) 453-6620
- Phone : (310) 453-4599
Second Address
- Dr. Earl Mark Gordon
- 2001 Santa Monica Blvd Suite # 765 - W
- Santa Monica, CA
- Zip : 90404-2102
- Fax : (310) 453-6620
- Phone : (310) 453-4599
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RN0300X | Nephrologist | G 35140 | CA |
National Provider Identifier
| NPI | 1053534925 |
|---|---|
| Provider Name | Dr. Earl Mark Gordon |
| First Address | Santa Monica, CA 90404-2102 |
| Second Address | Santa Monica, CA 90404-2102 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/04/2007 |
| Last Update Date | 02/11/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| A 46230 | (02) | |
| G 35140 | CALIFORNIA MED. LICENSE (01) | CA |
| ZZZ 73491 Z | (05) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.