Daniel Mark Gordon, M.D.

Primary specialty

Addiction Psychiatry PhysicianTaxonomy code 2084P0802X

License

G42749 Issued in CA

Practice address

620 California Blvd Ste P
San Luis Obispo, CA 93401-2590

Phone

(805) 544-8709

Fax

(805) 544-7809

NPI assigned

Apr 4, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1144342601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 CALIFORNIA BLVD STE P",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012590",
            "telephone_number": "805-544-8709",
            "fax_number": "805-544-7809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 CALIFORNIA BLVD STE P",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012590",
            "telephone_number": "805-544-8709",
            "fax_number": "805-544-7809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "DANIEL",
        "middle_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G42749",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "CA",
            "license": "G42749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven B Goodman, MD
• Karen E Goodrich, MD
• Nicole Goodwin, SOCIAL WORKER
• Brad Landon Goolsby, PA-C
• Ashlynn Nicole Gordon, D.O.
• Emily A Gordon, NP
• Russell E Gordon, LMFT
• Jesse Gortarez
• Suzanne Grace Gorter, M.F.T.
• Klaus T Gottlieb, MD

• Addiction Psychiatry Physician in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Addiction Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.