Provider Demographics
NPI:1720150733
Name:HANDS, GORDON R (CRNA)
Entity Type:Individual
Prefix:MR
First Name:GORDON
Middle Name:R
Last Name:HANDS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:858 DEER WILLOW CT
Mailing Address - Street 2:
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320
Mailing Address - Country:US
Mailing Address - Phone:805-376-2627
Mailing Address - Fax:805-376-2527
Practice Address - Street 1:858 DEER WILLOW CT
Practice Address - Street 2:
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320
Practice Address - Country:US
Practice Address - Phone:805-376-2627
Practice Address - Fax:805-376-2527
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN358994163W00000X
CANA1241207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology