Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Gordon Avery Lake, MD

Individual provider Adult Medicine Physician · NPI 1356379838

Gordon Avery Lake, MD is an Adult Medicine Physician in Oakland, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

350 30th St Ste 407
Oakland, CA 94609
Phone: (510) 419-0230
Fax: (510) 419-0273
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Specialties & licences

Adult Medicine Physician (primary) Taxonomy 207QA0505X · Licence G22921 (CA)

Record details

NPI number1356379838
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJune 30, 2006
Last updated in NPPESJanuary 19, 2016
Mailing address350 30th Street, Suite 407, Oakland, CA 94609

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