Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A63343 | CA |
N | 111NI0900X | Internist | A63343 | CA |
Y | 207SG0201X | Clinical Genetics (M.D.) | A63343 | CA |
NPI | 1508827718 |
---|---|
Provider Name | Dr. Ora Gordon |
First Address | West Hills, CA 91307-1910 |
Second Address | Burbank, CA 91505-4504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2006 |
Last Update Date | 14/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H56300 | (02) | CA |