Carl J. Gordon, M.D. Inc.

Primary specialty

Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X

License

G9592 Issued in CA

Legal business name

CARL J. GORDON, M.D. INC.

Practice address

6360 Wilshire Blvd
Suite 409
Los Angeles, CA 90048-5603

Phone

(323) 931-2606

Fax

(323) 931-2927

NPI assigned

Jul 11, 2008

Last updated

Jul 14, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Carl Jeffrey Gordon, M.D.

Title

President

Phone

(323) 931-2606

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247529600000",
    "number": "1780848473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6360 WILSHIRE BLVD",
            "address_2": "SUITE 409",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485603",
            "telephone_number": "323-931-2606",
            "fax_number": "323-931-2927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6360 WILSHIRE BLVD",
            "address_2": "SUITE 409",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485603",
            "telephone_number": "323-931-2606",
            "fax_number": "323-931-2927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARL J. GORDON, M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-11",
        "last_updated": "2009-07-14",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-931-2606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "CA",
            "license": "G9592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA MEDICAL LICENSE",
            "identifier": "G9592",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000G95920",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Carl Lauryssen MD Prof Corp.
• Carl Thomas Boylen M.D. Inc.
• Carla Belgarde-Duru DDS Inc (A-Plus Dental)

• Ophthalmologic Surgery Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Ophthalmologic Surgery Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2009; 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.