| Gordy Health | |
|
680 E Colorado Blvd Ste 180 Pasadena CA 91101-6144 | |
| (888) 467-3910 | |
| Not Available |
| Full Name | Gordy Health |
|---|---|
| Speciality | Internal Medicine |
| Location | 680 E Colorado Blvd Ste 180, Pasadena, California |
| Authorized Official Name and Position | Jie Shi Yan (OWNER) |
| Authorized Official Contact | 8884673910 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gordy Health 680 E Colorado Blvd Ste 180 Pasadena CA 91101-6144 Ph: (888) 467-3910 | Gordy Health 680 E Colorado Blvd Ste 180 Pasadena CA 91101-6144 Ph: (888) 467-3910 |
| NPI Number | 1588318703 |
|---|---|
| Provider Enumeration Date | 02/07/2022 |
| Last Update Date | 09/28/2022 |
| Medicare PECOS PAC ID | 2264828219 |
|---|---|
| Medicare Enrollment ID | O20220331001215 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588318703 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| Provider Name | Jieshi Yan |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1396744546 PECOS PAC ID: 2860417409 Enrollment ID: I20051012000616 |
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