1518124858 NPI number — APT, GINDI, GORDON & KERMAN, M.D.'S INC

Table of content: (NPI 1518124858)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518124858 NPI number — APT, GINDI, GORDON & KERMAN, M.D.'S INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
APT, GINDI, GORDON & KERMAN, M.D.'S INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518124858
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/11/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2080 CENTURY PARK E
Provider Second Line Business Mailing Address:
SUITE 800
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90067-2001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-277-2727
Provider Business Mailing Address Fax Number:
310-553-2135

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3756 SANTA ROSALIA DR
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90008-3606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-295-6611
Provider Business Practice Location Address Fax Number:
310-553-2135
Provider Enumeration Date:
05/22/2008

Additional Information

Authorized Official

Authorized Official Last Name:
GORDON
Authorized Official First Name:
KENNETH
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
310-277-2727

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  C36598 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10018 . This is a "J.J. GINDI, M.D. MES#" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 180004492 . This is a "J.J. GINDI RAILROAD MCR#" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 891994 . This is a "J.J. GINDI - DAVIS VISION" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: G2080559685654 . This is a "J.J. GINDI M.D. VSP#" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 00G210610 . This is a "J.J. GINDI BLUE SHIELD #" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: GR0071730 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: P-11051496 . This is a "K. L. GORDON, MULTI-PLAN #" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: G2080558723895 . This is a "K. L. GORDON, M.D. VSP#" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 33106001 . This is a "K. L. GORDON - DAVIS VISION" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 891994 . This is a "J.J. GINDI BLOCK VISION" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 891978 . This is a "K. L. GORDON BLOCK VISION" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: W13878A . This is a "MEDICARE GROUP PROVIDER #" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 10019 . This is a "K.L. GORDON, M.D. MES#" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 180025685 . This is a "K.L. GORDON M.D. RR MCR #" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 26923 . This is a "SPECTERA GROUP PROVIDER #" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: CA0783 . This is a "EYE MED PROVIDER #" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 00C365980 . This is a "K. L. GORDON, M.D. BL/SHLD" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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