SAMANTHA KELLY GORDON DO NPI 1184379828

NPI Information

NPI: 1184379828
Provider Name: SAMANTHA KELLY GORDON, DO
Classification: General Practice - 208D00000X
Entity Type: Individual
Address:
NAVAL MEDICAL CENTER SAN DIEGO 38400 BOB WILSON DRIVE
SAN DIEGO, CA
ZIP 92134
Phone: (760) 809-6315
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Samantha Kelly Gordon, DO is a general practice in San Diego, CA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee Samantha Kelly Gordon, DO NPI is 1184379828. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

NAVAL MEDICAL CENTER SAN DIEGO 38400 BOB WILSON DRIVE
SAN DIEGO, CA
ZIP 92134-001
Phone: (760) 809-6315

The enumeration date for this NPI number is 2/21/2022 and was last updated on 3/7/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	171000000X	Military Health Care Provider			No
2	208000000X	Pediatrics	0102208040	VIRGINIA	No
3	208D00000X	General Practice	0102208040	VIRGINIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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