GORDON AVERY LAKE

OAKLAND, CA
NPI1356379838
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207QA0505X Family Medicine, Adult Medicine
(Licence: CA  G22921)
Enumeration Date2006-06-30
Last Update Date2016-01-19
Business Address
-- GORDON AVERY LAKE MD
350 30TH STREET, SUITE 407
OAKLAND, CA 94609
Phone number: 510-419-0230
Mailing Address
-- GORDON AVERY LAKE MD
350 30TH STREET, SUITE 407
OAKLAND, CA 94609
Phone number: 510-419-0230
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