Gordon, Vicki R

Gordon, Vicki R is an sole proprietor health care provider with primary practice located at 550 E Washington Blvd , Crescent City CA 95531-8160. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Gordon, Vicki R can be contacted via phone (707) 496-5465.

Contact Information

Primary practice address
550 E Washington Blvd Crescent City CA 95531-8160
Phone: (707) 496-5465
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 4301083013 Michigan
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 127825 California
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X C127825 California

Profile Details

NPI number 1881613396
LBN Legal business name Gordon, Vicki R
Credentials MD PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 18th, 2006
Last updated Apr 20th, 2020 - about 6 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 1881613396 NPPES
Other 149719 UPIN NUMBER

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