Gordon Omar Matheson
Sports Medicine Doctor
341 Galvez St Arrillaga Mc 6150
Stanford
, California 94305-6106
Gordon Omar Matheson
Sports Medicine Doctor
341 Galvez St Arrillaga Mc 6150
Stanford
, California 94305-6106
(650) 725-2607
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About
Features
Specialties
- Sports Medicine Doctor
Languages spoken
- English
Location
First Address
- Gordon Omar Matheson
- 341 Galvez St Arrillaga Mc 6150
- Stanford, CA
- Zip : 94305-6106
- Fax : (650) 725-2607
- Phone : (650) 723-2257
Second Address
- Gordon Omar Matheson
- 341 Galvez St Arrillaga Mc 6150
- Stanford, CA
- Zip : 94305-6106
- Fax : (650) 725-2607
- Phone : (650) 723-2257
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 204C00000X | Sports Medicine Doctor | C43343 | CA |
National Provider Identifier
| NPI | 1255487518 |
|---|---|
| Provider Name | Gordon Omar Matheson |
| First Address | Stanford, CA 94305-6106 |
| Second Address | Stanford, CA 94305-6106 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/01/2007 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| F94522 | (02) | 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.