Active NPI
Christy Lee Gorden, MD
- Pediatrics Physician
- Yucaipa, CA
National Provider Identifier
1275637282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- G42484
- Practice address
- 33353 Yucaipa Blvd
Yucaipa, CA 92399-2018 - Phone
- (909) 790-7900
- Fax
- (909) 790-7058
- NPI assigned
- Sep 11, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | G42484 | CA | Primary |
Addresses
Primary practice location
33353 Yucaipa Blvd
Yucaipa, CA 92399-2018
Mailing address
PO Box 8188
Redlands, CA 92374-1388
Phone (909) 790-5071
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G42484 | Other | CA | MEDICAL BOARD OF CA |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G42484 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275637282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8188",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923741388",
"telephone_number": "909-790-5071",
"fax_number": "909-790-5774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33353 YUCAIPA BLVD",
"city": "YUCAIPA",
"state": "CA",
"postal_code": "923992018",
"telephone_number": "909-790-7900",
"fax_number": "909-790-7058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDEN",
"first_name": "CHRISTY",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "G42484",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL BOARD OF CA",
"identifier": "G42484",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yucaipa, CA
Sources for this page
- 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.