MEDICARE: MR. CHARLES ALBERT GORDON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	A66858	CA

General Provider Information

NPI Number	:	1821103631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHARLES ALBERT GORDON M.D.

Provider Business Mailing Address
First Line	:	176 S SYCAMORE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-2906
Country	:	US
Telephone Number	:	310-600-0896
Fax Number	:

Provider Business Practice Location Address
First Line	:	1059 S FAIRFAX AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-4402
Country	:	US
Telephone Number	:	310-600-0896
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	11/18/2021

Similar Medicare Providers

1790832699 — RAV TOV
Practice Location Address:

1061 S FAIRFAX AVE
LOS ANGELES, CA
90019-4402

Practice Phone: 323-937-5646
Practice Fax: 323-937-0491

1023356706 — HAYIM TOVIM 2 ADHC
Practice Location Address:

1061 S FAIRFAX AVE
LOS ANGELES, CA
90019-4402

Practice Phone: 310-420-4449
Practice Fax:

1881383057 — BLOOMING CHILD DEVELOPMENT
Practice Location Address:

1049 S FAIRFAX AVE
LOS ANGELES, CA
90019-4402

Practice Phone: 310-927-0126
Practice Fax: 310-362-8943

1477583474 — SHENEEKRA W ADAMS
Practice Location Address:

6060 W OLYMPIC BLVD
LOS ANGELES, CA
90036-4402

Practice Phone: 323-549-0567
Practice Fax: 323-549-0577

1245361856 — ETHAN CHUNG AN LEE DDS
Practice Location Address:

6046 WHITTIER BLVD
LOS ANGELES, CA
90022-4402

Practice Phone: 626-716-7078
Practice Fax: 323-726-3390

1700195062 — ALEXANDRA MCCLUNG LCSW
Practice Location Address:

3838 S CENTINELA AVE
LOS ANGELES, CA
90066-4402

Practice Phone: 310-463-6436
Practice Fax:

Directions to “ MR. CHARLES ALBERT GORDON M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.