Gordon Dwight Honda, MD
Individual provider Active NPI Anatomic Pathology & Clinical Pathology Physician · Clovis, CA
NPI 1699712430 · NPPES record last updated Dec 17, 2010
Key facts
- NPI
- 1699712430
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
- License
- A48027 (CA)
- Practice address
- 305 Park Creek Dr
Clovis, CA 93611-4426 - Phone
- (559) 326-2815
- Fax
- (559) 326-2801
- NPI assigned
- Jun 1, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Pathology
- Education
- Tulane University School of Medicine, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pathology Associates
Practice addresses (Care Compare)
305 Park Creek Dr
Clovis, CA 93611-4426
Phone (559) 326-2800
Hospital & facility affiliations
- Clovis Community Medical Center
- Community Regional Medical Center
- Adventist Health Hanford
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080718000679 | CA | Practitioner - Pathology | 5496758245 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A48027 | CA | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sierra Pathology Laboratory Inc | Current | Accepting new patients | |
| Saint Agnes Medical Center | Past | Accepting new patients | |
| Fresno Community Hospital and Medical Center | Past | Accepting new patients | |
| Crawford & Reiber Medical Associates | Anatomic Pathology & Clinical Pathology | Past | Accepting new patients |
| Saint Agnes Pathology Medical Group | Past | Accepting new patients |
Locations
2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000
305 Park Creek Dr
Clovis, CA 93611
Phone (559) 326-2800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | A48027 | CA | Yes |
Addresses
Primary practice location
305 Park Creek Dr
Clovis, CA 93611-4426
Mailing address
PO Box 2130
Clovis, CA 93613-2130
Phone (559) 326-2815
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 220033276 | Other | RAILROAD MEDICARE | |
| 00A480270 | Medicaid | CA |
Other providers in Clovis, CA
- Garlyn Elizabeth Hollingshead
- Ciera Rose Holm
- Amie Elizabeth Holmes
- Jonathan William Holmes
- Diane Lynne Holsworth
- Honest Citizens Network
- Hope & Healing Family Therapy Center Inc
- Lauren Moriah Horsley
- Eric S. Hoshiko
- Heather Leighanne Hoskins
All providers in Clovis, CA · Anatomic Pathology & Clinical Pathology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.