Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | G20574 | CA |
NPI | 1295995322 |
---|---|
Provider Name | Dr. Howard Richard Gordon |
First Address | Piedmont, CA 94610-1124 |
Second Address | Piedmont, CA 94610-1124 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2008 |
Last Update Date | 12/06/2008 |