Marvin Isaac Gordon MD a Professional Corporation

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

A83747 Issued in CA

Legal business name

MARVIN ISAAC GORDON MD A PROFESSIONAL CORPORATION

Practice address

3300 E South St Ste 207
Lakewood, CA 90805-4549

Phone

(562) 602-5503

NPI assigned

Jan 17, 2012

Organization subpart

No

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

Authorized official

Name

Marvin Isaac Gordon, M.D.

Title

Doctor/Owner

Phone

(310) 622-3600

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1326758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573689600000",
    "number": "1891066221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 N FORMOSA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900362817",
            "telephone_number": "310-622-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 E SOUTH ST STE 207",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "908054549",
            "telephone_number": "562-602-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARVIN ISAAC GORDON MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-17",
        "last_updated": "2019-11-14",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "ISAAC",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "310-622-3600",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A83747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Lakewood, CA
• Providers in Lakewood, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; 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.