Ryan James Gordon, SFIDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

9955 Pomerado Rd BLDG 20300
San Diego, CA 92131-2041

Phone

(858) 537-8334

NPI assigned

Aug 6, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1375747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1902238579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9955 POMERADO RD BLDG 20300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921312041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9955 POMERADO RD BLDG 20300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921312041",
            "telephone_number": "858-537-8334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3455 Senn Rd",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921365084",
            "country_code": "US",
            "telephone_number": "858-663-2722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3455 Senn Rd",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921365084",
            "country_code": "US",
            "telephone_number": "858-663-2722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "RYAN",
        "middle_name": "JAMES",
        "credential": "SFIDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Gordon, M.D.
• Monisha Carol Gordon, PH.D.
• Nancy Margaret Gordon, LCSW
• Richard L Gordon, PHARM. D.
• Robert Gordon, BCBA
• Susan G. Gordon, LCSW
• Talia Gordon, PT, DPT
• Taylor Gordon
• Thomas William Gordon, IDC
• Trinity Gordon

• Independent Duty Corpsman in San Diego, CA
• Providers in San Diego, CA by specialty
• Independent Duty Corpsman in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.