Individual provider Active NPI

L Stephen Gordon, M.D.

  • Pediatric Cardiology Physician
  • Arcadia, CA
National Provider Identifier
1750572020
Registry record updated Aug 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
G124580 Issued in CA
Practice address
301 W Huntington Dr
Suite 415
Arcadia, CA 91007-3462
Phone
(626) 445-5552
Fax
(626) 445-4411
NPI assigned
Aug 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X G124580 CA Primary

Addresses

Primary practice location

301 W Huntington Dr
Suite 415
Arcadia, CA 91007-3462

Mailing address

301 W Huntington Dr
Suite 415
Arcadia, CA 91007-3462
Phone (626) 445-5552

Other identifiers 1

IdentifierTypeStateIssuer
00G124580MedicaidCA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G124580CAMDPediatric Cardiology Physician

Practice roles (7 of 8)

OrganizationSpecialtyStatusNew patients
Ahmc Garfield Medical Center LP Past Accepting new patients
Childrens Cardiac Medical Clinic Pediatric Cardiology Past Accepting new patients
Emanate Health Foothill Presbyterian Hospital Past Accepting new patients
Usc Arcadia Hospital Past Accepting new patients
Childrens Hospital of Los Angeles Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186358400000",
    "number": "1750572020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W HUNTINGTON DR",
            "address_2": "SUITE 415",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910073462",
            "telephone_number": "626-445-5552",
            "fax_number": "626-445-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W HUNTINGTON DR",
            "address_2": "SUITE 415",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910073462",
            "telephone_number": "626-445-5552",
            "fax_number": "626-445-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "L STEPHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "G124580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G124580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.

Verify at the official NPI Registry.