Alvin I Gore, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A79731 Issued in CA

Practice address

1165 Montgomery Dr # 1W20
Santa Rosa, CA 95405-4801

Phone

(707) 303-8307

Fax

(707) 303-1992

NPI assigned

Jun 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: agore1657739@oc.providencedirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• San Diego Center for Family Health

  • Internal Medicine Physician
  • San Diego, CA
  • NPI 1306959721

  Family Medicine

  NPD (past)
• Conemaugh Health Initiatives

  • Family Medicine Physician
  • New Paris, PA
  • NPI 1487724597
  NPD (past)
• Conemaugh Valley Memorial Hospital

  • Emergency Medicine Physician
  • Johnstown, PA
  • NPI 1346200920
  NPD (past)
• Windber Hospital, Inc.

  • General Acute Care Hospital
  • Windber, PA
  • NPI 1275620536
  NPD (past)

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1326042821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 MONTGOMERY DR # 1W20",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054801",
            "telephone_number": "707-303-8307",
            "fax_number": "707-303-1992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 MONTGOMERY DR # 1W20",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054801",
            "telephone_number": "707-303-8307",
            "fax_number": "707-303-1992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORE",
        "first_name": "ALVIN",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD417462",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A79731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001858789",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "agore1657739@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1165 Montgomery Dr # 1W20",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954054801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eric David Gordon, M.D.
• Lily Katherine Gordon
• Megan Gordon
• Vanessa Gordon
• Brandi Anne Gordonoff, CAADE
• Debra Gorman, LAC
• Jesse Gormley
• Melissa Gory
• Jay Michael Gospe, M.D.
• Angelica Goss

• Family Medicine Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.

Verify at the official NPI Registry.