Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
GORDON AVERY LAKE, MD
Active Sole ProprietorGORDON AVERY LAKE, MD is a Adolescent Medicine healthcare provider located in OAKLAND, California. NPI 1356379838 is currently active in the NPPES registry. Verify at CMS.
Adolescent Medicine · OAKLAND, CA
Registration Details
- NPI Number
- 1356379838
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 30, 2006 (20.165776193343 yrs)
- Last Updated
- Jan 19, 2016
- License
-
G22921 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
350 30TH STREET, SUITE 407OAKLAND, CA, 94609Browse CA providers · Browse ZIP 94609
- Phone
- 5104190230
- Fax
- 5104190273
- Primary Specialty
-
Adolescent Medicine
207QA0505X
Other Adolescent Medicine Providers in OAKLAND, CA
| Name | Credential | NPI |
|---|---|---|
| DR. PAUL ROBERT PERCHONOCK | MD | 1700857919 |
| VANESSA LITMAN | MD | 1124100110 |
| GRACE G LAT | M.D. | 1528196326 |
| JAZMIN WISE | — | 1558190751 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.