Provider Demographics
NPI:1518124858
Name:APT, GINDI, GORDON & KERMAN, M.D.'S INC
Entity Type:Organization
Organization Name:APT, GINDI, GORDON & KERMAN, M.D.'S INC
Other - Org Name:CRENSHAW EYE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:L
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-277-2727
Mailing Address - Street 1:2080 CENTURY PARK E
Mailing Address - Street 2:SUITE 800
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-2001
Mailing Address - Country:US
Mailing Address - Phone:310-277-2727
Mailing Address - Fax:310-553-2135
Practice Address - Street 1:3756 SANTA ROSALIA DR
Practice Address - Street 2:SUITE 100
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-3606
Practice Address - Country:US
Practice Address - Phone:323-295-6611
Practice Address - Fax:310-553-2135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC36598207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA10018OtherJ.J. GINDI, M.D. MES#
CA180004492OtherJ.J. GINDI RAILROAD MCR#
CA891994OtherJ.J. GINDI - DAVIS VISION
CAG2080559685654OtherJ.J. GINDI M.D. VSP#
CA00G210610OtherJ.J. GINDI BLUE SHIELD #
CAGR0071730Medicaid
CAP-11051496OtherK. L. GORDON, MULTI-PLAN #
CAG2080558723895OtherK. L. GORDON, M.D. VSP#
CA33106001OtherK. L. GORDON - DAVIS VISION
CA891994OtherJ.J. GINDI BLOCK VISION
CA891978OtherK. L. GORDON BLOCK VISION
CAW13878AOtherMEDICARE GROUP PROVIDER #
CA10019OtherK.L. GORDON, M.D. MES#
CA180025685OtherK.L. GORDON M.D. RR MCR #
CA26923OtherSPECTERA GROUP PROVIDER #
CACA0783OtherEYE MED PROVIDER #
CA00C365980OtherK. L. GORDON, M.D. BL/SHLD
CA10019OtherK.L. GORDON, M.D. MES#
CA180025685OtherK.L. GORDON M.D. RR MCR #
CA891978OtherK. L. GORDON BLOCK VISION