Camille Gordon

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

54318 Issued in CA

Practice address

255 N White Rd Ste 200
San Jose, CA 95127-1966

Phone

(408) 503-7600

NPI assigned

Nov 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Camille Gordon Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553385600000",
    "number": "1083780712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E EL CAMINO REAL",
            "address_2": "MEDICAL STAFF DEPT.",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940402833",
            "telephone_number": "408-739-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N WHITE RD STE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951271966",
            "telephone_number": "408-503-7600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2734 El Camino Real",
            "address_purpose": "LOCATION",
            "city": "Santa Clara",
            "state": "CA",
            "postal_code": "950513007",
            "country_code": "US",
            "telephone_number": "408-739-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "CAMILLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2019-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "5214",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "54318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAMILLE",
            "last_name": "GORDON",
            "credential": "PA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Sreepriya Gopalkrishnan, M.D.
• Umamaheswari Gopalrathnam, M.D
• Neha Goraksh
• Gordon R. Cohen, M.D., Inc.
• Calvin O. Gordon, MD
• Linda M Gordon, M.D.
• Lisa A Gordon, DMD
• Malcolm Gordon, MD
• Rachael Gordon, PMHNP
• Rosa Gorel-Wong

• Physician Assistant in San Jose, CA
• Providers in San Jose, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2019; 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.