NPIMap

Organization Active NPI

H.W. Gordon, M.D., Medical Corporation

  • Anatomic Pathology & Clinical Pathology Physician
  • Ukiah, CA
National Provider Identifier
1780678433
Registry record updated Jan 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
H.W. GORDON, M.D., MEDICAL CORPORATION
Practice address
275 Hospital Dr
Dept of Pathology
Ukiah, CA 95482-4531
Phone
(707) 462-3111
Fax
(707) 463-7509
NPI assigned
Sep 8, 2005
Last updated
Jan 30, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2014

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

Authorized official

Name
Herschel W Gordon, M.D.NPI 1326033846
Title
President
Phone
(707) 462-3111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X Primary

Addresses

Primary practice location

275 Hospital Dr
Dept of Pathology
Ukiah, CA 95482-4531

Mailing address

275 Hospital Dr
Dept of Pathology
Ukiah, CA 95482-4531
Phone (707) 462-3111

Other identifiers 2

IdentifierTypeStateIssuer
00C207190MedicaidCA
00C207191MedicaidCA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391040000000",
    "number": "1780678433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 HOSPITAL DR",
            "address_2": "DEPT OF PATHOLOGY",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824531",
            "telephone_number": "707-462-3111",
            "fax_number": "707-463-7509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 HOSPITAL DR",
            "address_2": "DEPT OF PATHOLOGY",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824531",
            "telephone_number": "707-462-3111",
            "fax_number": "707-463-7509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H.W. GORDON, M.D., MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-08",
        "last_updated": "2014-01-30",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "HERSCHEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-462-3111",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C207190",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C207191",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ukiah, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; 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.