Gordon A Booth, M.D.

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

G28665 Issued in CA

Practice address

740 Nordahl Rd
#117
San Marcos, CA 92069-3543

Phone

(615) 778-4066

NPI assigned

Mar 20, 2007

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)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Patient First Richmond Medical Group PLLC

  • Family Medicine Physician
  • Glen Allen, VA
  • NPI 1689603748
  NPD (past)

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254873600000",
    "number": "1972628071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5080 SPECTRUM DR",
            "address_2": "SUITE 1200 WEST",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014648",
            "telephone_number": "972-364-8000",
            "fax_number": "214-775-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 NORDAHL RD",
            "address_2": "#117",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920693543",
            "telephone_number": "615-778-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "GORDON",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2009-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "CA",
            "license": "G28665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ivana Bogovac
• David Steele Bohline, PHD
• Ann Cottrell Bolander, MD
• Ryan Bond
• Kimberly A Bonn
• Katherine Borders, PT
• Michael F Bosse, PHARMD
• Dianne Marie Botta, DPT
• Michelle Renae Bouchard, 1-14-16524
• Andrew Bove

• Occupational Medicine Physician in San Marcos, CA
• Providers in San Marcos, CA by specialty
• Occupational Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.