Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 203557 | LA |
N | 207QA0401X | Family Doctor - Addiction Medicine | MD.203557 | LA |
NPI | 1629270962 |
---|---|
Provider Name | Cesar Z Gonzales |
First Address | West Monroe, LA 71291-8304 |
Second Address | West Monroe, LA 71291-5327 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2007 |
Last Update Date | 28/09/2021 |