Brian Louis Gordon, M.D

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

F03058 Issued in CA

Practice address

600 N Highland Springs Avenue
Banning, CA 92220

Phone

(510) 350-2777

NPI assigned

Jun 7, 2006

Last updated

Jul 17, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216252800000",
    "number": "1093755043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL STREET",
            "address_2": "STE 920",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081803",
            "telephone_number": "510-350-2600",
            "fax_number": "510-879-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N HIGHLAND SPRINGS AVENUE",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "92220",
            "telephone_number": "510-350-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "BRIAN",
        "middle_name": "LOUIS",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2008-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "F03058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G562070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Monique Gomez
• Jessica Gonzales
• Kelli Gonzales
• Mayra Yazmin Gonzalez
• Olivia Gonzalez
• Desiree Michelle Gottfried, LMFT
• Kacherion Grant
• Brandan Dean Gray, STUDENT
• Cynthia Ann Gray, CADC-II, ICADC
• Grdentistry Gilberto Olagueddsaprofessionalcorporation

• Emergency Medicine Physician in Banning, CA
• Providers in Banning, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; 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.