Healthcare Provider Details

I. General information

NPI: 1154375632
Provider Name (Legal Business Name): RHONDA K GORDON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 06/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

334 S PATTERSON AVE SUITE 203
SANTA BARBARA CA
93111-2400
US

IV. Provider business mailing address

915 N MILPAS ST 2ND FLOOR
SANTA BARBARA CA
93103-2331
US

V. Phone/Fax

Practice location:
  • Phone: 805-617-7858
  • Fax: 805-963-8880
Mailing address:
  • Phone: 805-617-7858
  • Fax: 805-963-8880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA65857
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: