Gordon Omar Matheson, M.D., PH.D.

Primary specialty

Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X

License

C43343 Issued in CA

Practice address

341 Galvez St
Arrillaga MC 6150
Stanford, CA 94305-6106

Phone

(650) 723-2257

Fax

(650) 725-2607

NPI assigned

Jan 26, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255487518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 GALVEZ ST",
            "address_2": "ARRILLAGA MC 6150",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943056106",
            "telephone_number": "650-723-2257",
            "fax_number": "650-725-2607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 GALVEZ ST",
            "address_2": "ARRILLAGA MC 6150",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943056106",
            "telephone_number": "650-723-2257",
            "fax_number": "650-725-2607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHESON",
        "first_name": "GORDON",
        "middle_name": "OMAR",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "CA",
            "license": "C43343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tarik Fathy Massoud, MD
• Rustin A Massoudi, MD
• Martha Meredith Masters, MD
• Howard Cooper Masuoka, MD
• Elizabeth Wanja Mathenge, MD
• Manoj Chalakuzhy Mathew, M.D.
• Mohamad Matout, MD
• Brigid Therese Matts, NP
• Vamsi Maturi
• Martin Matuszczak, M.D.

• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Stanford, CA
• Providers in Stanford, CA by specialty
• Sports Medicine (Neuromusculoskeletal Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.