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General NPI Number Information
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NPI Number | 1992162911
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Entity Type | Organization
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Legal Business Name | GORDIAN MEDICAL IV, INC.
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Dates
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Enumeration Date | 01/21/2016
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Last Update Date | 01/03/2024
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Provider Practice Location Address
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Address Line | 3610 CENTRAL AVE, FLOOR 4 SUITE 40
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City | RIVERSIDE
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State | CA
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Zip | 92506-5900
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Country | US
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Telephone | 951-736-9000
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Fax | 877-380-8282
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Provider Business Mailing Address
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Address Line | 750 THE CITY DR S STE 225
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City | ORANGE
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State | CA
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Zip | 92868-4976
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Country | US
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Telephone | 714-556-0200
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Fax | 877-380-8282
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY BOWMAN
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Credential |
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Telephone | 714-556-0200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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