Gordon M Rick

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

CLF11078 Issued in CA

Legal business name

GORDON M RICK

Practice address

5190 Governor Dr
Suite 106
San Diego, CA 92122-2847

Phone

(858) 784-0600

Fax

(858) 784-0604

NPI assigned

Mar 14, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Gordon Marvin Rick, DDS

Title

Owner/Director

Phone

(858) 784-0600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Scripps Oral Pathology Service Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lee James Slater, DDS, MS

  • Oral and Maxillofacial Pathology Dentistry
  • San Diego, CA
  • NPI 1336112721
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370217600000",
    "number": "1063683357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5190 GOVERNOR DR",
            "address_2": "SUITE 106",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921222847",
            "telephone_number": "858-784-0600",
            "fax_number": "858-784-0604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5190 GOVERNOR DR",
            "address_2": "SUITE 106",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921222847",
            "telephone_number": "858-784-0600",
            "fax_number": "858-784-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON M RICK",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-14",
        "last_updated": "2013-06-03",
        "status": "A",
        "authorized_official_last_name": "RICK",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "MARVIN",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "858-784-0600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CLF11078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAB43007F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Scripps Oral Pathology Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bruce Lane Gorden, MFT
• Valerie Gorden
• Julianna L Gorder, PSY.D.
• Neomi T Gordillo
• Ari Gordin
• Gordon Schanzlin New Vision Institute, Inc. a Professional Medical Cor
• Alison Gordon
• Alison Nicole Gordon, MD
• Ayana Marie Gordon
• Belinda Diane Gordon, MSC, MFCT, RASI

• Clinical Medical Laboratory in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.