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General NPI Number Information
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NPI Number | 1689647000
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Entity Type | Individual
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Provider Name | RICHARD L GORDON PHARM. D.
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Gender | Male
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 34800 BOB WILSON DR NAVAL MEDICAL CENTER
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City | SAN DIEGO
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State | CA
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Zip | 92134-1098
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Country | US
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Telephone | 619-532-9495
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Fax |
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Provider Business Mailing Address
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Address Line | 10771 BLACK MOUNTAIN RD SPC 74
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City | SAN DIEGO
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State | CA
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Zip | 92126-2940
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Country | US
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Telephone | 858-829-2543
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 43718
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License Number State | CA
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