Gordon, Robert Larry

Gordon, Robert Larry is an individual health care provider with primary practice located at 795 E 2Nd St Suite 2, Pomona CA 91766-2007. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Gordon, Robert Larry can be contacted via phone (909) 706-3794.

Contact Information

Primary practice address
795 E 2Nd St Suite 2 Pomona CA 91766-2007
Phone: (909) 706-3794
Fax: (909) 469-5228
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 5274TPL California

Profile Details

NPI number 1285692509
LBN Legal business name Gordon, Robert Larry
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2006
Last updated Aug 19th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285692509 NPPES
California MEDICAID YYY48587Y

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