Active NPI
Leo Gordon, M.D.
- Surgery Physician
- West Hollywood, CA
National Provider Identifier
1992719918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- G36120
- Practice address
- 8700 Beverly Blvd
CS-Occ
West Hollywood, CA 90048-1804 - Phone
- (310) 423-1892
- Fax
- (310) 659-3928
- NPI assigned
- Jul 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | G36120 | CA | Primary |
Addresses
Primary practice location
8700 Beverly Blvd
CS-Occ
West Hollywood, CA 90048-1804
Mailing address
8700 Beverly Blvd
CS-Occ
West Hollywood, CA 90048-1804
Phone (951) 303-3391
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G36120 | CA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992719918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8700 BEVERLY BLVD",
"address_2": "CS-OCC",
"city": "WEST HOLLYWOOD",
"state": "CA",
"postal_code": "900481804",
"telephone_number": "951-303-3391",
"fax_number": "951-346-3627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8700 BEVERLY BLVD",
"address_2": "CS-OCC",
"city": "WEST HOLLYWOOD",
"state": "CA",
"postal_code": "900481804",
"telephone_number": "310-423-1892",
"fax_number": "310-659-3928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "LEO",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "G36120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Hollywood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.