Provider Demographics
NPI:1376395053
Name:GORDON, THOMAS JAMES (DO)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:JAMES
Last Name:GORDON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2480 SONOMA ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-3027
Mailing Address - Country:US
Mailing Address - Phone:530-225-7800
Mailing Address - Fax:
Practice Address - Street 1:2480 SONOMA ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-3027
Practice Address - Country:US
Practice Address - Phone:530-225-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program