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General NPI Number Information
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NPI Number | 1871789420
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Entity Type | Organization
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Legal Business Name | JEAN GORDON, M.D. PH.D., INC.
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Dates
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Enumeration Date | 09/18/2007
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Last Update Date | 09/18/2007
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Provider Practice Location Address
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Address Line | 2660 SOLACE PL STE C
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-4316
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Country | US
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Telephone | 650-938-6559
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Fax | 650-938-6510
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Provider Business Mailing Address
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Address Line | 2660 SOLACE PL STE C
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-4316
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Country | US
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Telephone | 650-938-6559
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Fax | 650-938-6510
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Authorized Official
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Title or Position | M.D.
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Name | DR. JEAN GORDON
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Credential | M.D., PH.D,
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Telephone | 650-938-6559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G60973
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License Number State | CA
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