Gordon M Rick

NPI 1063683357 - Clinical Medical Laboratory - 291U00000X

NPI Details
NPI 1063683357
Enumeration Date 03/14/2008
Last Updated 06/03/2013
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name GORDON MARVIN GORDON
Position OWNER/DIRECTOR
Phone (858) 784-0600
Fax (858) 784-0604
Practice Location
5190 GOVERNOR DR
SUITE 106
SAN DIEGO CA, 92122-2847, US
Phone (858) 784-0600
Fax (858) 784-0604
Business Location
5190 GOVERNOR DR
SUITE 106
SAN DIEGO CA, 92122-2847, US
Phone (858) 784-0600
Fax (858) 784-0604
Toxanomy
Taxonomy Code 291U00000X
License State California
License Number CLF11078
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According to our database, Gordon M Rick NPI is 1063683357, taxonomy code is 291U00000X and license number is CLF11078, license state is located at California. Gordon M Rick physically located at 5190 Governor Dr, San Diego CA, 92122-2847. NPI Number 1033115704 has the healthcare provider type.

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1063683357 NPI number is provided on an as is basis without warranty of any kind. 1063683357 is maintained by the National Plan & Provider Enumeration System. The contents of Gordon M Rick are for informational purposes only.