Individual provider · Type 1 NPI

Jacob Samuel Gordner, MD

Student in an Organized Health Care Education/Training Program · Stanford, CA

NPI number 1124762026 Active

Practice location

300 Pasteur Dr
Stanford, CA 94305-2296

Call (650) 725-1812 Map

Mailing address

103-182 Princess St
Kingston, ON K7L 1B1

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XA175900 (CA)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1124762026

Jacob Samuel Gordner, MD's National Provider Identifier is 1124762026, issued on Apr 26, 2022. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Stanford, CA. The record was last updated on Apr 26, 2022.