Organization Active NPI

Ronald Gordon Medical Corporation

  • Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
  • Daly City, CA
National Provider Identifier
1407464654
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Emergency Medicine) PhysicianTaxonomy code 207PE0005X
Legal business name
RONALD GORDON MEDICAL CORPORATION
Practice address
901 Campus Dr Ste 206B
Daly City, CA 94015-4932
Phone
(650) 356-8800
NPI assigned
Jul 14, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Authorized official

Name
Ronald Samuel Gordon, MDNPI 1063460517
Title
Ceo
Phone
(216) 956-8994

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Emergency Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207PE0005X Primary

Addresses

Primary practice location

901 Campus Dr Ste 206B
Daly City, CA 94015-4932

Mailing address

53765 Via Dona
La Quinta, CA 92253-7841
Phone (216) 956-8994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250418001131 CA Part B Supplier - Clinic/Group Practice 9335664697 Receives reassigned benefits from 6 practitioners
Practice locations: Daly City, CA

National Provider Directory

National Provider Directory

Locations

901 Campus Dr
Ste 206B
Daly City, CA 94015
Phone (216) 965-3152

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740009600000",
    "number": "1407464654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53765 VIA DONA",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922537841",
            "telephone_number": "216-956-8994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 CAMPUS DR STE 206B",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940154932",
            "telephone_number": "650-356-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD GORDON MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-14",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "SAMUEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "216-956-8994",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207PE0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.