Provider Demographics
NPI:1346670452
Name:GORDON, KAREN (DAOM)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:GORDON
Suffix:
Gender:F
Credentials:DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 W VILLA ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91103-3343
Mailing Address - Country:US
Mailing Address - Phone:213-448-4254
Mailing Address - Fax:
Practice Address - Street 1:379 W BELLEVUE DR
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-1833
Practice Address - Country:US
Practice Address - Phone:213-448-4254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-26
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC15193171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist