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General NPI Number Information
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NPI Number | 1386064145
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Entity Type | Organization
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Legal Business Name | GORDON C LUNDY MD A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 04/21/2014
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Last Update Date | 06/01/2020
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Provider Practice Location Address
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Address Line | 2100 WEBSTER ST STE 117
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-2374
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Country | US
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Telephone | 415-923-3015
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Fax | 415-923-3501
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Provider Business Mailing Address
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Address Line | 2100 WEBSTER ST STE 117
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-2374
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Country | US
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Telephone | 415-923-3015
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Fax | 415-923-3501
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Authorized Official
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Title or Position | PRESIDENT
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Name | GORDON C LUNDY
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Credential | MD
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Telephone | 415-923-3015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | G60433
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License Number State | CA
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