Active NPI
Lawrence Warren Gordon, RPH
- Pharmacist
- Quincy, CA
National Provider Identifier
1093482028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 46255
- Practice address
- 40 E Main St
Quincy, CA 95971-9701 - Phone
- (530) 283-1899
- NPI assigned
- Aug 26, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 46255 | CA | Primary |
Addresses
Primary practice location
40 E Main St
Quincy, CA 95971-9701
Mailing address
PO Box 737
Quincy, CA 95971-0737
Phone (530) 591-7769
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46255 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629936000000",
"number": "1093482028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 737",
"city": "QUINCY",
"state": "CA",
"postal_code": "959710737",
"telephone_number": "530-591-7769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 E MAIN ST",
"city": "QUINCY",
"state": "CA",
"postal_code": "959719701",
"telephone_number": "530-283-1899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "LAWRENCE",
"middle_name": "WARREN",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-26",
"last_updated": "2021-08-26",
"certification_date": "2021-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "46255",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Quincy, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.