Robert B Gordon, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

C34624 Issued in CA

Practice address

954 W Foothill Blvd
Suite a
Upland, CA 91786-3782

Phone

(909) 946-4222

Fax

(909) 946-8243

NPI assigned

Nov 22, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Foothills Psychological Services, Inc.

  • Psychologist
  • Upland, CA
  • NPI 1336121888

  Psychiatry

  Medicare reassignment NPD
• One Health Center, Inc.

  • Community Health Clinic/Center
  • Upland, CA
  • NPI 1265272736
  Medicare reassignment
• One Health Center, Inc.

  • Community Health Clinic/Center
  • Montclair, CA
  • NPI 1992679443

  Psychiatry

  NPD

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348444800000",
    "number": "1528041654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13193 CENTRAL AVE",
            "address_2": "SUITE 200",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917107200",
            "telephone_number": "909-902-9111",
            "fax_number": "909-902-9199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 W FOOTHILL BLVD",
            "address_2": "SUITE A",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863782",
            "telephone_number": "909-946-4222",
            "fax_number": "909-946-8243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "ROBERT",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2012-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C34624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C346240",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Good Hands Acupuncture Upland, Inc.
• Good Hope Home Health Care Inc
• Good Shepherd Hospice, LLC
• Marieanne Goodwin, DC
• Lyric N Goosby, DOULA
• Wallace George Gosney, M.D.
• Bjorn Lars Gothberg
• Lien Governanti, PHARM.D.
• Trisna Gozali, NP-C
• Gracious Heart Hospice & Palliative Care , Inc.

• Psychiatry Physician in Upland, CA
• Providers in Upland, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2012; 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.